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Background:  There is limited evidence on the analgesic efficacy of opioids during percutaneous intravenous central catheter (PICC) insertion in preterm infants.

Aim:  To assess the analgesic and procedural efficacy of low‐dose remifentanil infusion during PICC in preterm infants.

Methods:  Fifty‐four neonates [mean gestational age (±sd) 28 ± 2 weeks; birth weight 1126 ± 337 g] were randomly assigned to remifentanil infusion at 0.03 mcg·kg⁻¹·min⁻¹ (R) or placebo (C) in addition to 0.3 ml of 12% sucrose per os and non‐nutritive sucking.

Results:  Validated pain scales [Neonatal Infants Pain Scale (NIPS) and Premature Infants Pain Profile (PIPP)] administered at the baseline T0, skin preparation T1, needle insertion T2, and recovery T3, revealed differences in mean NIPS scores (C 5.3 ± 1.3 vs R 4.2 ± 1.4 at T1 and C 5.0 ± 1.3 vs R 3.4 ± 1.3 at T2) and PIPP scores (C 9.3 ± 1.6 vs R 7.1 ± …