Multidimensional pain assessment in premature neonates: a pilot study

Abstract

Objective: To describe the physiologic and behavioral responses of premature neonates to a painful stimulus.

Design: Descriptive.

Setting: Secondary-level neonatal unit in a large metropolitan university teaching hospital.

Participants: Forty neonates between 32 and 34 weeks' postconceptual age and less than 5 days' postnatal age.

Main outcome measures: Physiologic (heart rate, oxygen saturation, and intracranial pressure) and behavioral (facial expression and cry) outcomes observed during a routine heel stick.

Results: Physiologic responses were significant, but were not specific to pain. Behavioral responses were more promising and indicated that premature neonates were capable of responding in a manner similar to full-term neonates.

Conclusions: Premature neonates are capable of expressing their pain in a manner similar to healthy, full-term neonates. Factors that alter this response were not clearly delineated. Further research is needed to determine more precise patterns of response in this age group.