Parent/Nurse Controlled Analgesia in the Neonatal Intensive Care Unit

Inclusion Criteria:

- Surgery Location:

- Abdominal or Thoracic

- First surgery only

Age:

- Born ≥ 34-44 weeks post-menstrual age

- Weight: Weight at birth or current weight ≥2 kg Intubated or extubated

Prior opioid exposure:

- < 2 days of continuous exposure

- if history of > 2 day continuous exposure, must be off continuous drip for a week

- Intermittent exposure ≤ 2 days prior to surgery Neonates exposed to chronic opioids in
utero *In utero exposure to Selective Seretonin Reuptake Inhibitors and illicit drugs
will be screened for and annotated.

At least 1 parent is English-speaking

Exclusion Criteria:

- Surgery Type:

- Cardiac, Patent Ductus Arteriosus Ligation; Omphalocele (if intubated
pre-operatively)

Diagnoses:

• Necrotizing Enterocolitis; Diaphragmatic hernia (unless thoracoscopically repaired);
Chemically or physiologically paralyzed Receiving vasopressors Receiving acetaminophen or a
benzodiazepine (lorazepam or midazolam) ≤ 24 h before surgery Patients with any of the
following: Epidural; Oscillating ventilator