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Evidence is currently limited to short-term procedural use, with no solid data available on cognitive, motor, or behavioral outcomes, underscoring the need for follow-up studies ( Practical recommendations emphasize slow titration, avoidance of large or rapid boluses, continuous cardiorespiratory monitoring in adequately equipped neonatal units, and proactive planning for alternative analgesic strategies when remifentanil is discontinued, particularly to prevent rebound discomfort after procedural use (119, 120, 125)

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