Defining pain in newborns: need for a uniform taxonomy?

Anand, Kanwaljeet J. S.

doi:10.1111/apa.13936

Cited by 46 publications

(66 citation statements)

References 90 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Infants in the neonatal intensive care unit (NICU) are capable of experiencing chronic pain (Debillon, Zupan, Ravault, Magny, & Dehan, 2001; Ilhan et al., 2019; Pillai Riddell et al., 2009), but little is known about its development (Anand, 2017; Ilhan et al., 2019), definition (van Ganzewinkel & Andriessen, 2017), treatment or prevention (Anand, 2017; Boyle, Bradshaw, & Blake, 2018). Chronic pain in older populations (Friedrichsdorf et al., 2016; Treede et al., 2015), defined as pain lasting longer than 3 months, has obvious limitations when applied to infants.…”

Section: Introductionmentioning

confidence: 99%

Trajectories of post‐surgical pain in infants admitted to neonatal intensive care

İlhan

Galea

Pacey

et al. 2020

European Journal of Pain

View full text Add to dashboard Cite

Background The aim of this study was (a) to statistically identify distinct trajectories of pain following surgery in infants less than 6 months of age, and (b) to compare these trajectories to descriptions of chronic pain in infants in the neonatal intensive care unit (NICU). Methods This was a retrospective medical record review of infants admitted to a NICU between 2008 and 2018 following surgery. All infants who underwent one major procedure to the abdomen or thorax and returned to the NICU following surgery were included. Pain was assessed regularly using a validated Pain Assessment Tool. Group‐based trajectory analysis was used to determine the trajectory of recovery from pain following surgery. Results A total of 726 infants were included in the study. A two‐group trajectory model, defined as typical and atypical pain trajectories, was selected. The typical group (n = 467) consisted of infants who had significantly fewer days (1.5 ± 2.3 vs 5.3 ± 5.5, p < .001) and recorded instances of pain (2.0 ± 3.4 vs 9.7 ± 10.5, p < .001) compared to infants in the atypical group (n = 259). The incidence of iatrogenic neonatal abstinence syndrome was greater in the atypical than the typical group (11% vs 5%, p = .001). Conclusions This study has revealed two distinct pain trajectories in infants after surgery. While recovery from pain occurs within days in the typical group, the atypical group demonstrates pain for a significantly longer period, often weeks and months following surgery. This latter group adheres closely to current descriptions of chronic pain in infants.

show abstract

Section: Introductionmentioning

confidence: 99%

Trajectories of post‐surgical pain in infants admitted to neonatal intensive care

İlhan

Galea

Pacey

et al. 2020

European Journal of Pain

View full text Add to dashboard Cite

show abstract

“…One possible reason for the difference in prevalence estimates between pain assessment tools is that they may not have been measuring the same type of pain. One review explored the possibility of three non‐acute pain types in neonates, including prolonged, persistent and chronic . Because the psychometric validation of these tools was not based on an agreed definition of non‐acute pain, they may not have been equipped to measure all types of non‐acute pain states in this population.…”

Section: Discussionmentioning

confidence: 99%

Systematic review and meta‐analysis suggest that varying prevalence of non‐acute pain in critically ill infants may be due to different definitions

et al. 2019

View full text Add to dashboard Cite

Aim:Our aim was to quantify the prevalence of non-acute pain in critically ill infants and to identify how non-acute pain was described, defined and assessed.Methods: This systematic review and meta-analysis used multiple electronic databases to search for papers published in any language to March 2018: 2029 papers were identified, and 68 full texts were screened. Studies reporting the prevalence of non-acute pain in infants younger than 2 years and admitted to critical care units were included. The extracted data included the use of non-acute pain descriptions, definitions and pain assessment tools. Results:We included 11 studies published between 2002 and 2018 that comprised 1204 infants from Europe, the USA, Canada and India. They were prospective observational (n = 7) and retrospective observational (n = 1) studies and randomised controlled trials (n = 3). The prevalence of non-acute pain was 0%-76% (median 11%).Various pain assessment tools were used, and only two could be pooled. This gave a pooled prevalence of 3.7%-39.8%. A number of different descriptors were used for non-acute pain, and all of these were poorly defined. Conclusion:The prevalence of non-acute pain in infants admitted to critical care units varied considerably. This could have been because all the studies used different definitions of non-acute pain.

show abstract

“…Its control is a moral and ethical act, and its treatment decreases the physiological, behavioural and hormonal deviations it causes [1]. Considering the early and late effects of neonatal pain, studies are directed to factors, which possibly affect pain sensitivity in new-borns.…”

Section: Introductionmentioning

confidence: 99%

Factors affecting the severity of procedural pain in new-borns

Petleshkova¹,

Krasteva²,

Dragusheva³

et al. 2018

biomedicalresearch

View full text Add to dashboard Cite

In recent years, the objectification and control of neonatal pain has caused many discussions. Given its early and late effects, researchers' efforts are aimed at minimizing the impact of maternal and childrelated factors, with a possible effect on pain sensitivity in new-borns. Our aim is to study the influence of maternal factors (daily intake of one or more cups of coffee and bacterial vaginosis during pregnancy, birth mechanism, blood group and Rhesus factor) and child-related factors (gestational age, gender, blood group and Rhesus factor) on the severity of procedural pain, caused by puncture of the heel. The present study includes 67 infants carried to term and aged 72-84 h, born by varying birth mechanisms and with an optimal Apgar score. By video surveillance before, during and after the procedure, the pain was assessed using the Neonatal Infant Pain Scale (NIPS). The results were measured 30 s and 5 min after the heel puncture. The following statistical methods were used: Kruskal-Wallis test, X 2 assay (Chisquared test), Student's t-test and Mann-Whitney's u-test, with a factor of significance of p<0.05. At the 30-s mark, there was no statistically significant difference in the severity of pain among the new-borns in the groups: pregnant women, which have consumed coffee and had bacterial vaginosis during the pregnancy. The mechanism of birth, gender and Rhesus factor of the new-born and mother did not change the severity of pain. New-borns with a larger gestational age and those from mothers with the blood group AB showed a significantly increased response to procedural pain. At the 5-min mark, none of the studied factors associated with the mother and new-born had a significant effect on the degree of pain. The influence of maternal and child related factors on the severity of procedural pain in new-borns is limited.

show abstract

Defining pain in newborns: need for a uniform taxonomy?

Cited by 46 publications

References 90 publications

Trajectories of post‐surgical pain in infants admitted to neonatal intensive care

Trajectories of post‐surgical pain in infants admitted to neonatal intensive care

Systematic review and meta‐analysis suggest that varying prevalence of non‐acute pain in critically ill infants may be due to different definitions

Factors affecting the severity of procedural pain in new-borns

Contact Info

Product

Resources

About