Yesterday in my NICU an ENT Dr. cut a baby's frenulum (sp.?) WITHOUT any pain control. I didn't have the baby but was in the room. I suggested pain control out loud to the nurse and the resident. The MD had already told the parents he wouldn't need anything for pain. "I only cut 3mm" he said. Hey, let me cut 3 MM out of YOUR mouth! That's what I felt like saying. The resident mentioned Morphine and he ignored her. The baby screamed for a few minutes, not long, HOWEVER don't you think he could have used topical lidocaine or SOMETHING? They numb babies now for circs! Why not the mouth?
I have braces and I know how painful the mouth can be. I was given topical lidocaine by my orthodontist, so I know it works.
Have any of you ever seen this frenulectomy procedure without meds?
The baby got Tylenol AFTERWARDS, oh well. I just thought it was MEAN.
And a deeply entrenched belief (courtesy of said ancient respiratory doc) that the tiniest shred of independent respiratory effort trumps any amount of pain, no matter how large, because they "won't remember it". Seriously. Someone said that to me as an honest attempt at justification the other day.
Hell, they had to sedate one of my daughters to keep her ventilated! She kept trying to extubate herself ( and eventually did). Luckily, our NICU seemed much better about making sure the babies had pain relief.
Thanks for the reply. I was afraid it was something like that (dinosaur nursing culture)...
An update: both my manager and CNS encouraged me to "go up the chain of command" if I'm not happy with the care the babies get. This incident was reported to our NICU director and he is supposed to talk to that ENT doc who think babies don't feel pain when they get their frenulum snipped! I am happy with the response I got, it's just these ancient doctors (but htis one was young looking??) that don't get it, or they just don't care. What really surprised me is how this Dr. convinced the parents it was fine to give the baby nothing at all!
Neonates in Intensive Care Endure Painful Procedures, Mostly Without Analgesia CME/CE
July 11, 2008 — Over a 2-week period, neonates in intensive care underwent a median of 10 painful procedures per day, 79.2% without analgesia, in a study from Paris.
"The number of painful procedures is so high that the first step to improve procedural pain management must significantly reduce these numbers," the authors, led by Ricardo Carbajal, MD, from the Hôpital d'enfants Armand Trousseau, in Paris, France, write.
"The knowledge that some vulnerable neonates underwent 153 tracheal aspirations or 95 heel sticks in a 2-week period should elicit a thoughtful and relevant analysis on the necessity and the risk/benefit ratio for our clinical practices," they observe.
The study is published in the July 2 issue of the Journal of the American Medical Association.
:banghead: 
elizabells, BSN, RN
2,094 Posts
And a deeply entrenched belief (courtesy of said ancient respiratory doc) that the tiniest shred of independent respiratory effort trumps any amount of pain, no matter how large, because they "won't remember it". Seriously. Someone said that to me as an honest attempt at justification the other day.