Abstract
This research paper aims to investigate if oxidative stress biomarkers increase after a painful procedure in term newborns and if nonpharmacological approaches, or sex, influence pain degree, and the subsequent OS. 83 healthy term newborns were enrolled to receive 10% oral glucose or sensorial saturation (SS) for analgesia during heel prick (HP). The ABC scale was used to score the pain. Advanced oxidation protein products (AOPP) and total hydroperoxides (TH) as biomarkers of OS were measured at the beginning (early-sample) and at the end (late-sample) of HP. The early-sample/late-sample ratio for AOPP and TH was used to evaluate the increase in OS biomarkers after HP. Higher levels of both AOPP and TH ratio were observed in high degree pain (4–6) compared with low degree pain score (0–3) (AOPP: p = 0.049; TH: p = 0.001). Newborns receiving SS showed a significantly lower pain score (p = 0.000) and AOPP ratio levels (p = 0.021) than those without. Males showed higher TH levels at the end of HP (p = 0.005) compared to females. The current study demonstrates that a relationship between pain degree and OS exists in healthy full-term newborns. The amount of OS is gender related, being higher in males. SS reduces pain score together with pain-related OS in the newborns.
Highlights
Nociceptive pathways are working from an early stage of fetal development [1]
All the newborns were quiet and relaxed and a significant increase in the ABC pain score was observed after heel prick (HP)
According to the type of analgesia, a significant decrease of the ABC pain score was found in infants treated with sensorial saturation (SS) compared to that in those with 10% 10% oral glucose solution (OG)
Summary
Nociceptive pathways are working from an early stage of fetal development [1]. neonates have functional ascending (excitatory) pain pathways by 24 weeks’ gestation, but descending (inhibitory) pathways appear immature until approximately 48 weeks’ gestation [2, 3]. Neonates have many other immature pain responses, which expose them to a greater intensity of pain for a prolonged period of time [4]. Ill fullterm newborns and preterm infants are prone to significant painful stimuli at a time when the developing nervous system is notoriously sensitive to changes in sensory experience [6]. There is increasing clinical evidence that painful stimulations elicit specific behaviors, activate the somatosensory cortex, and stimulate neuroendocrine and physiological stress responses, leading to short- and long-term clinical consequences in newborns [7,8,9,10]. Full-term born children, who needed neonatal intensive care, showed enhanced perceptual sensitization to prolonged painful stimulation and hypoalgesia to brief heat pain stimuli at the age of 9–14 years [13]. Identifying underlying mechanisms of pain-related consequences, along with reliable biomarkers to combine with pain scales, is of paramount importance for future researches
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