Objective:

To describe neonatal pain assessment and management practices in Hungarian level III NICUs.

Approach:

• Survey Design: A prospective multicenter cross-sectional survey was conducted using an anonymous online questionnaire distributed to heads of all Hungarian level III NICUs.
• Survey Participation: Fourteen of the 21 Hungarian level III NICUs participated in the survey, achieving a response rate of 67%.

Key Findings:

• Only14%ofNICUsreportedusingacomprehensivewrittenpainmanagementguideline.14%ofNICUsroutinelyusedvalidatedneonatalpainassessmentscales.Non-pharmacologicalpainmanagementmethodswereusedinallunits,withsignificantvariabilityintypeandfrequency,includingkangaroocare,breastfeeding,expressedbreastmilk,pacifier,facilitatedtucking,sensorialsaturation,musictherapy,massage,oralsucrose,andco-bedding.PostoperativeanalgesiawasroutinelyadministeredinallsurgicalNICUs,butonly40%reportedproceduralanalgesia.86%ofunitsusedroutineanalgesiaduringmechanicalventilation.

Interpretation:

Neonatal pain assessment and management practices in Hungarian NICUs are inconsistent, with a lack of standardized guidelines and validated assessment tools.

Limitations:

• Thestudywasexploratoryandreliedonself-reportedpractices,whichmayoverestimateadherencetorecommendations.ThesurveyexcludedlevelIINICUs,limitingthegeneralizabilityoffindings.

Conclusion:

Wider implementation of standardized guidelines and validated pain assessment tools is warranted.