Pain management, morphine administration, and outcomes in preterm infants: a review of the literature.

Infants in the Neonatal Intensive Care Unit may experience a myriad of painful procedures and stressful experiences. Pain management for infants requiring mechanical ventilation is complex and challenging especially in the preterm population. Many infants may not receive analgesia, primarily due to the unknown long-term neurodevelopmental effects of morphine exposure on the developing brain. Currently, there is no consensus on how to treat pain related to mechanical ventilation due to conflicting scientific evidence lacks clarity and certainty about the role of morphine in pain in preterm infants. The Advance Practice Neonatal Nurse must make the best use of available information about morphine analgesia for the preterm infant, and use it to guide policy and practice for infants. The Advance Practice Neonatal Nurse must use his/her clinical expertise to judicially balance the risks and benefits of morphine analgesia, when used, and tailor the treatment plan to each infant's specific needs.