10/02/2026
Ottawa, Ontario — Tuesday February 10, 2026
Babies in the neonatal intensive care unit (NICU) often need strong pain relief after surgery or while on mechanical ventilators. Opioids are commonly used, but growing evidence shows they may affect long-term term brain development. So how can infants be protected from pain while also limiting unnecessary opioid exposure?
A new study led by Emanuela Ferretti explored whether evidence-based pain management guidelines implemented by a multi-disciplinary team could standardize care and reduce opioid use in 170 postoperative and mechanically ventilated newborns.
“By standardizing how we assess and treat pain, we were able to cut opioid exposure in more than half – without leaving babies in pain.” – Emanuela Ferretti
The study found that after the local CHEO NICU Pain Management Guidelines were put in place, cumulative opioid exposure dropped by 55%, without a cost to newborns’ comfort or safety. Pain and sedation scores stayed within target ranges, hospital stays were unchanged, and there was no increase in complications or mortality. At the same time, documentation of bedside pain assessments tripled, helping care teams respond more consistently to each infant’s needs.
The research shows that clear guidelines and team-based care can safely change practice, reducing opioid exposure without sacrificing pain management for newborns. The local CHEO guidelines have been adopted as an example by CCSO for the entire province of Ontario, providing a framework for other NICU departments to implement similar interventions.