Journal article
A global cross-sectional survey on neonatal analgosedation: unveiling global trends and challenges through latent class analysis
- Abstract:
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Purpose
This study aims to analyze global prescribing patterns for analgosedation in neonates during four critical care scenarios. The research explores existing patterns, their association with geographic and sociodemographic index (SDI), and adherence to evidence-based practices.
Methods
Data from a 2024 global survey of 924 responses to 28 questions were analyzed, focusing on four items for their high variability: premedication in intubation (Q17), sedation in preterm (Q19) and full-term newborns (Q23), and perinatal asphyxia (Q26). Latent class analysis (LCA) classified neonatal intensive care unit (NICU) prescriptions into patterns, assigning participants to the most likely class. Demographic variables, including geographic region and SDI, were compared using chi-square tests to assess associations.
Results
Three distinct prescribing patterns emerged for each scenario. In premedication during intubation, Europe and North America predominantly used Class 1, adhering to guidelines with fentanyl, atropine, and muscle relaxants. In contrast, Class 2, standard in Asia and Latin America-Caribbean, primarily utilized fentanyl and midazolam, with rare use of atropine and muscle relaxants. For analgosedation in newborns, higher-SDI NICUs favored fentanyl, while lower-SDI NICUs preferred midazolam or morphine combinations. In perinatal asphyxia cases, fentanyl was the leading choice in Class 3, especially in Europe. Dexmedetomidine use was limited, primarily appearing in Class 1 NICUs.
Conclusion
The study highlights substantial regional variability in neonatal analgosedation, influenced by SDI and geography. Despite established guidelines, gaps in evidence-based implementation persist. These findings underscore the need for global standardization of neonatal care protocols and further research on the long-term safety of midazolam and dexmedetomidine.
- Publication status:
- Published
- Peer review status:
- Peer reviewed
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- Files:
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(Preview, Supplementary materials, pdf, 252.2KB, Terms of use)
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(Preview, Version of record, pdf, 1.6MB, Terms of use)
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- Publisher copy:
- 10.1007/s00431-025-06074-z
Authors
Contributors
+ ESPR Special Interest Group for Neonatal Pain
- Role:
- Contributor
+ Bhatt, A
- Institution:
- University of Oxford
- Division:
- MSD
- Department:
- Paediatrics
- Role:
- Contributor
- ORCID:
- 0000-0001-6206-0576
+ Hartley, C
- Institution:
- University of Oxford
- Division:
- MSD
- Department:
- Paediatrics
- Role:
- Contributor
- ORCID:
- 0000-0002-7981-0836
+ Roehr, C
- Institution:
- University of Oxford
- Division:
- MSD
- Department:
- Nuffield Department of Population Health
- Role:
- Contributor
+ Baxter, L
- Institution:
- University of Oxford
- Division:
- MSD
- Department:
- Paediatrics
- Role:
- Contributor
- ORCID:
- 0000-0001-9548-7162
- Publisher:
- Springer
- Journal:
- European Journal of Pediatrics More from this journal
- Volume:
- 184
- Issue:
- 4
- Article number:
- 241
- Publication date:
- 2025-03-12
- Acceptance date:
- 2025-03-02
- DOI:
- EISSN:
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1432-1076
- ISSN:
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0340-6199
- Language:
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English
- Keywords:
- Pubs id:
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2118425
- Local pid:
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pubs:2118425
- Deposit date:
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2025-04-15
- ARK identifier:
Terms of use
- Copyright holder:
- Arribas et al.
- Copyright date:
- 2025
- Rights statement:
- © The Author(s) 2025. Open Access. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder.
- Licence:
- CC Attribution (CC BY)
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