Multidimensional pain assessment of preterm newborns at the 1st, 3rd and 7th days of life.

Ana Beatriz Mello Serpa,Ruth Guinsburg,Kelsy Catherina Nena Areco,Rita de Cássia Xavier Balda,Clóvis Araújo Peres,Amélia Miyashiro Nunes dos Santos

doi:10.1590/s1516-31802007000100006

Ana Beatriz Mello Serpa, Ruth Guinsburg + Show 4 more

Open Access

https://doi.org/10.1590/s1516-31802007000100006

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Abstract

It is challenge to assess and treat pain in premature infants. The objective of this study was to compare the multidimensional pain assessment of preterm neonates subjected to an acute pain stimulus at 24 hours, 72 hours and seven days of life. Prospective cohort study, at Universidade Federal de São Paulo. Eleven neonates with gestational age less than 37 weeks that needed venepuncture for blood collection were studied. The exclusion criteria were Apgar score < 7 at five minutes, presence of any central nervous system abnormality, and discharge or death before seven days of life. Venepuncture was performed in the dorsum of the hand, and the heart rate, oxygen saturation and pain scales [Neonatal Facial Coding System (NFCS), Neonatal Infant Pain Scale (NIPS), and Premature Infant Pain Profile (PIPP)] were assessed at 24 hours, 72 hours and 7 days of life. NFCS and NIPS were evaluated prior to procedure (Tpre), during venepuncture (T0), and two (T2) and five (T5) minutes after needle withdrawal. Heart rate, O2 saturation and PIPP were measured at Tpre and T0. Mean values were compared by repeated-measurement analysis of variance. The pain parameters did not differ at 24 hours, 72 hours and 7 days of life: heart rate (p = 0.22), oxygen saturation (p = 0.69), NFCS (p = 0.40), NIPS (p = 0.32) and PIPP (p = 0.56). Homogeneous pain scores were observed following venepuncture in premature infants during their first week of life.

Highlights

Diagnostic and/or therapeutic procedures are required for the survival of critically ill newborn babies, and the possible pain generated by such procedures has been a source of concern
The pain parameters did not differ at 24 hours, 72 hours and 7 days of life: heart rate (p = 0.22), oxygen saturation (p = 0.69), Neonatal Facial Coding System (NFCS) (p = 0.40), Neonatal Infant Pain Scale (NIPS) (p = 0.32) and Premature Infant Pain Profile (PIPP) (p = 0.56)
Prematurity, postnatal age, coexistent diseases and the sensitivity of the healthcare professionals who need to interpret the pain measurement tools applied to newborn infants further complicate pain evaluation among patients of this age.[22]

Summary

Introduction

Diagnostic and/or therapeutic procedures are required for the survival of critically ill newborn babies, and the possible pain generated by such procedures has been a source of concern. Specific analgesic or anesthetic treatment is utilized for only 3% of newborn infants undergoing painful procedures, while nonspecific analgesia is given to 30% of them for reasons other than the procedures per se.[3] According to Simons et al.,1 15-32% of 1,375 patients-day in NICU during their first two weeks of life received some dose of analgesia every day. These data are concordant with those of Prestes et al.,[2] who found that, out of 1,025 patients-day in NICU, 23% received at least one dose of analgesics

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