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Abstract Neonates subjected to various degrees of painful procedures in hospitals. There are several long-term and short term effects of poorly managed acute pain in neonates. Short term effects are due to the stress response that was found to be greater in magnitude but shorter in duration in neonates compared with adults during the same operation. (95) The stress response leads to serious catabolism of protein, fat and carbohydrate that might cause metabolic acidosis, hypoglycemia, hyperglycemia and electrolyte imbalances especially in premature or sick infants leading to increased morbidity and mortality. (97) Fentanyl is the most used analgesic opioid in the neonatal intensive care unit. Fentanyl acts as an agonist binding to μ and k opioid receptors and has the properties of an analgesic, sedative and anesthetic. (84) It is widely used to provide rapid short-lived pain relief during surgery. |