Abstract

Abstract Understanding the pain physiology of the preterm infant is essential to the provision of effective pain prevention and pain management. Peripheral and ascending pain pathways are mature by 20 weeks of gestation so infants are completely capable of feeling pain. The expression of pain in preterm infants is well documented. However, the immature descending pain pathway and lack of serotonin until 6 to 8 weeks after birth along with a greater density of pain receptors in the skin mean that preterm infants experience more severe pain than adults. The duration of the pain is longer, and the consequences of repeated painful procedures create permanent structural changes in the vulnerable nervous system of the preterm infant. Prevention of pain may preclude the permanent structural changes in the preterm nervous system, and adequate management when pain is necessary may prevent the psychologic and emotional consequences of repeated pain in the preterm infant. Copyright © 2001 by W.B. Saunders Company

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