Abstract
Enhanced Recovery After Surgery (ERAS) recommendations for multi-modal, opioid-limiting analgesia have been shown to be effective in paediatric patients. However, neonatal-specific protocols are limited, and protocols that address non-pharmacological approaches are rare. Through systematic review and modified Delphi consensus with anaesthesiologists, paediatric surgeons and researchers, we developed non-pharmacological recommendations to improve perioperative neonatal pain management. Evidence from 37 articles of variable quality informed these recommendations. Our consensus resulted in four recommendations: (1) use of sweet-tasting solutions, (2) non-nutritive sucking, (3) skin-to-skin and (4) music therapy. These recommendations aim to reduce neonatal opioid usage alongside pharmacological therapies. PROSPERO registration number: CRD42021265273.