Analgesia in neonatal fractures

[moliyen]

Which analgesic would suit better for term stable neonates with fractures?

[fcardona]

I would follow the WHO's pain ladder recommendation, i.e. first non-opioids (+adjunctive if necessary), then weak opioids and use frequent CRIES (http://www.ncbi.nlm.nih.gov/pubmed/15499150)(or PIPP) scores to assess if pain is adequately adressed.
I guess the type of fractured bone would play a role in how much discomfort/pain one has to expect. I would also put in a good effort to find out the cause of the fracture.

[Stefan Johansson]

Almost all fractures I have come acros have been osteoporotic fractures in extr preterm infants, the remaining being traumatic fractures after traumatic instrumental deliveries (vag or CS).

In addition to analgesic, good and comfortable fixation (as suggested by the ortoph people) is important for pain.