Inclusion Criteria:  All inborn and outborn newborns admitted to the neonatal intensive care unit (NICU) who received mechanical ventilation administered through an endotracheal tube. Newborn on mechanical ventilator for at least 72 hours.  Exclusion Criteria:  Known genetic or chromosomal disorders, The need for postoperative analgesic therapy during the study period, Major congenital anomaly, Those who received drugs like midazolam, paracetamol, morphine, muscle relaxants, phenobarbital, phenytoin, and chloral hydrate during the study period. Probable rapid extubation.