Parent/Nurse Controlled Analgesia in the Neonatal Intensive Care Unit

Inclusion Criteria: * Surgery Location: * Abdominal or Thoracic * First surgery only Age: * Born ≥ 34-44 weeks post-menstrual age * Weight: Weight at birth or current weight ≥2 kg Intubated or extubated Prior opioid exposure: * \< 2 days of continuous exposure * if history of \> 2 day continuous exposure, must be off continuous drip for a week * Intermittent exposure ≤ 2 days prior to surgery Neonates exposed to chronic opioids in utero \*In utero exposure to Selective Seretonin Reuptake Inhibitors and illicit drugs will be screened for and annotated. At least 1 parent is English-speaking Exclusion Criteria: * Surgery Type: * Cardiac, Patent Ductus Arteriosus Ligation; Omphalocele (if intubated pre-operatively) Diagnoses: • Necrotizing Enterocolitis; Diaphragmatic hernia (unless thoracoscopically repaired); Chemically or physiologically paralyzed Receiving vasopressors Receiving acetaminophen or a benzodiazepine (lorazepam or midazolam) ≤ 24 h before surgery Patients with any of the following: Epidural; Oscillating ventilator