{
  "abstract": "Accurate assessment of pain, agitation, and sedation in mechanically ventilated neonates is fundamental to neonatal intensive care but remains challenging because neonates cannot self-report pain, and behavioral and physiological responses are influenced by illness severity, medication exposure, and developmental maturity. This systematic review evaluated the reliability, validity, and clinical utility of the Neonatal Pain, Agitation and Sedation Scale (N-PASS) in mechanically ventilated neonates. The review was conducted in accordance with the PRISMA 2020 guidelines. PubMed/MEDLINE, Scopus, and CINAHL were systematically searched from each database's inception through March 2026, with supplementary screening of reference lists. Primary quantitative studies evaluating the N-PASS in mechanically ventilated neonates or reporting separate data for this population were eligible. Owing to methodological heterogeneity, the findings were synthesized narratively, and the risk of bias was assessed using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Analytical Cross-Sectional Studies. Four studies conducted in India, China, Iran, and Egypt met the inclusion criteria. The available evidence indicated high to excellent inter-rater reliability and moderate to good internal consistency, while the findings supported the convergent, criterion, and discriminant validity of the N-PASS in mechanically ventilated neonates. Evidence also supports its clinical utility for routine assessment of pain, agitation, and sedation in neonatal intensive care. Nevertheless, the evidence base remains limited and heterogeneous, particularly with respect to the sedation component and the discrimination of intermediate levels of sedation. Further well-designed multi-center studies involving larger and more homogeneous populations are warranted to strengthen the evidence supporting the use of the N-PASS in mechanically ventilated neonates.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Medicine, National and Kapodistrian University of Athens, Athens, GRC.",
    "First Department of Anesthesiology, Aretaieion University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, GRC.",
    "Department of Midwifery, University of West Attica, Athens, GRC."
  ],
  "article_type": "review article",
  "arxiv": null,
  "author_total": 7,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Niki Sotiropoulou"
    },
    {
      "affs": [
        1
      ],
      "name": "Kassiani Theodoraki"
    },
    {
      "affs": [
        2
      ],
      "name": "Antigoni Sarantaki"
    },
    {
      "affs": [
        2
      ],
      "name": "Angeliki Bolou"
    },
    {
      "affs": [
        2
      ],
      "name": "Vikentia Harizopoulou"
    },
    {
      "affs": [
        1
      ],
      "name": "Athanasia Tsaroucha"
    },
    {
      "affs": [
        2
      ],
      "name": "Dimitra Metallinou"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/d7mqz9dks2mks.bib",
  "cited_by": 0,
  "doi": "10.7759/cureus.116730",
  "fulltext_url": "https://europepmc.org/articles/PMC13688587",
  "id": "d7mqz9dks2mks",
  "issns": [
    "2168-8184"
  ],
  "landing_url": "https://europepmc.org/article/MED/42924017",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2735|Pediatric Pain Management Techniques"
    ]
  ],
  "openalex": "W7213976213",
  "pdf_url": "https://europepmc.org/articles/PMC13688587?pdf=render",
  "pmcid": "PMC13688587",
  "pmid": "42924017",
  "published": "2026-09-22",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/d7mqz9dks2mks.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:21:02Z",
      "native_id": "MED:42924017",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42924017"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2735|Pediatric Pain Management Techniques",
      "subfield": "reproductive-child"
    }
  ],
  "title": "Reliability and Validity of the Neonatal Pain, Agitation, and Sedation Scale in Mechanically Ventilated Neonates: A Systematic Review.",
  "title_text": "Reliability and Validity of the Neonatal Pain, Agitation, and Sedation Scale in Mechanically Ventilated Neonates: A Systematic Review.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:21:02Z",
  "url": "https://research.draconitic.com/paper/d7mqz9dks2mks",
  "venue": "Cureus",
  "versions": []
}