Even routine painful procedures can be harmful for the newborn

Abstract

Stressful events can damage neonatal brain through a complexity of events including free radical (FR) generation. We examined whether pain provoked by a routine heel prick can generate an increase in potentially harmful FR in neonatal blood. To this aim, advanced oxidation protein products (AOPP) and total hydroperoxide (TH) concentrations were measured at the beginning (sample A) and at the end (sample B) of each sampling in 64 babies (corrected age: 37.2+/-2.7 weeks) who underwent heel prick for routine blood tests. We scored pain of every procedure in all newborns. No differences were detected between AOPP and TH blood concentrations at the beginning and at the end of heel prick sampling, considering the whole cohort of babies. Conversely, a significant increase was observed between AOPP and TH blood concentrations considering only those babies who showed the highest pain intensity. When babies' pain was high (ABC score >or=4), mean AOPP and TH blood levels increased significantly; in this case, mean AOPP values increased from 53.5microm/l (SD=41.6) to 63.2microm/l (SD=44.3) and TH values from 218.3UCarr (SD=89.2) to 228.7UCarr (SD=93.3), with a significant p value of 0.02 and 0.036, respectively. A significant correlation was also found between AOPP blood levels ratio (sample B/sample A) in each baby, and the correspondent level of pain. These data show that even common routine procedures can be potentially harmful for the newborn if they provoke a high level of pain.

Hospitalized Infants Who Hurt: A Sweet Solution With Oral Sucrose

“…2012;32 [1]: [61][62][63][64][65][66][67][68][69] radicals. [9][10][11][12][13][14][15][16][17][18][19][20] The destructive interplay of pain, hypoxia, and toxic effects caused by free radicals leads to poor outcomes. Table 1 lists conditions of newborns that are associated with these effects.…”

“…Table 1 lists conditions of newborns that are associated with these effects. [9][10][11][12][13][14][15][16][17][18][19][20] Nurses must consider the long-term deleterious effects of repeated unmanaged pain for patients in the NICU, including preterm babies. 9 Table 2 lists several routine invasive and painful procedures infants must undergo during hospitalization.…”

Pain in neonates: long-term consequences and treatment

“…Les gestes « systématiques » réalisés en routine doivent être prohibés. Des gestes quotidiens comme les « dextro » ou les gaz du sang, réalisés plusieurs fois par jour chez un même patient et semblant peu douloureux, peuvent être délétères et avoir des conséquences à long terme, notamment par la libé-ration de radicaux libres particulièrement nocifs sur des tissus en développement [10]. Les gestes douloureux, en dehors de l'urgence, doivent être programmés afin de permettre la réalisation d'une analgésie préventive adaptée, les ponctions veineuses doivent être préférées aux ponctions au talon plus douloureuses, et le matériel utilisé doit être adé-quat (par exemple des lancettes mécaniques plutôt que des lancettes manuelles pour les ponctions au talon).…”

Development of atraumatic heel-stick procedures by combined treatment with non-nutritive sucking, oral sucrose, and facilitated tucking: A randomised, controlled trial

“…Accumulated pain and stress can harm the premature infant brain by increasing intracranial pressure and oxygen desaturation (Grunau et al, 2006;Hall and Anand, 2005), generating free radicals that can damage fast-growing brain and lung tissues as well as neuronal membranes (Bellieni et al, 2009;Saugstad, 2005). Thus, premature infants are at risk of severe health problems and disabilities such as retinopathy, chronic lung disease, and periventricular leukomalacia (Robertson et al, 2009;Sun et al, 2009).…”