Repeated painful stimuli may affect pain response in neonates of more than 34 weeks post-conceptional age: A case control study

Astha Agarwal,Navratan Kumar Gupta,Rajesh Chaudhary,Amit Upadhyay,Archana Dubey

doi:10.4038/sljch.v48i3.8761

Abstract

Objective: To evaluate the effect of repeated painful stimuli on pain response in neonates of more than 34 weeks post conceptional age. Method: A case control study was done. Cases comprised neonates more than 34 weeks gestational age having more than ten repeated painful procedures. Controls include age and sex matched neonates with less than three painful procedures. The outcome variables were the duration of cry and Modified Facial Coding Score (MFCS) after intramuscular injection. Results: A total of 100 neonates were enrolled (50 as cases and 50 as controls). Median (interquartile range) of duration of cry in case and control groups was 26 (20-48 seconds) and 30.5 (20-78 seconds) respectively (p >0.05). MFCS score at immediate, 1 and 3 minutes was not statistically significant in the two groups (p >0.05). Conclusions: Exposure to frequent painful stimuli in early neonatal life may not significantly alter pain response in neonates more than 34 weeks post conceptional age. Sri Lanka Journal of Child Health, 2019; 48(3): 251-255

Highlights

Various studies have established that the pathways for pain perception are functional from early fetal life, but this neural system is still immature at birth[1]
Are exposed to repetitive painful stimuli in the form of heel lances, venipuncture, insertion of nasogastric tubes, suction etc. Exposure to such painful stimuli may potentially alter the subsequent response to pain in neonates[2,3,4,5,6]
Various studies have reported that exposure to acute pain during the neonatal period causes exaggerated pain responses for a period more than what is required for the complete healing of the initial tissue injury[9,10,11,12,13,14,15]

Summary

Introduction

Various studies have established that the pathways for pain perception are functional from early fetal life, but this neural system is still immature at birth[1].

Objectives

Methods

Results

Discussion

Conclusion