EVALUATION OF PERCEPTION OF EXTEROCEPTIVE SENSATIONS IN PRETERM NEONATES-A PILOT STUDY

Abstract

Aim: Preterm infant is deprived of various in-utero sensory experiences which have been documented as risk factor for prevalence of broad range of neurodevelopmental impairment in preterm infants. The present study evaluates the pain processing pattern in preterm neonates with and without known abnormalities using the Premature Infant Pain Profile (PIPP)-a 7 indicator pain measure that include three behavioural (facial actions: brow bulge, eye squeeze and nasolabial furrow), two physiological (heart rate and oxygen saturation), and two contextual (gestational age and behavioural state). Method: Neonates were randomly observed for receiving one of the following procedures: Dry cotton swab for simple touch (T), Cold and warm water wet cotton swabs for recording temperature perceptions (Tp), venous puncture in the back of the hand (P), considered as a painful stimulus; or alcohol swab friction on the back of the hand (F), considered as a distressing but not painful stimulus. A neonatologist evaluated physiologic and behavioral pain parameters. The evaluation of the perception includes utilizing Neonatal Infant Pain Scale (NIPS) and PIPP. Results: The mean pain score is 8.04 which is considered as moderate as per PIPP table. The standard deviation is 3.517. The probability distribution of pain is normal. Conclusion: The pain perception according to the recorded score is moderate in the premature neonates and the perception score is comparatively high in preterm neonates with known abnormalities. The infants born at 29-31 weeks of gestational age group showed greatest changes in the hemodynamic patterns during exteroceptive painful stimulation. KEY WORDS: premature, neonates, Premature Infant Pain Profile, PIPP, Neonatal Infant Pain Scale, NIPS, preterm birth