Fetal pain perception and pain management

Velde, Marc Van de; Jani, Jacques; Buck, Frederik De; Deprest, Jan

doi:10.1016/j.siny.2006.02.012

Cited by 49 publications

(24 citation statements)

References 34 publications

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“…58 In some investigations, it was concluded that the human fetus can feel pain after 24 GW, and that the fetus may feel pain even before 24 GW. 59,60 Reissland et al 61 suggested that healthy fetuses progress towards an increasingly complete pain/distress expression as they mature. These authors argued that the increasing frequency of fetal pain/distress with advancing gestation might be an adaptive process, being beneficial to the fetus after birth to obtain his/her parents' love.…”

Section: Fetal Painmentioning

confidence: 99%

Current status of fetal neurodevelopmental assessment: Four‐dimensional ultrasound study

Hata

2016

J of Obstet and Gynaecol

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With the latest advent of four-dimensional (4-D) ultrasound, fetal neurobehavioral or neurodevelopmental assessment can be easily and readily performed. Using this technique, typical fetal movements and behavioral patterns have become apparent in all three trimesters of pregnancy. In twin pregnancy, 4-D ultrasound facilitates the precise evaluation of inter-twin contact and intra-pair stimulation. New fetal neurobehavioral assessment tests, such as Kurjak's Antenatal Neurodevelopmental Test and the Fetal Observable Movement System, may reflect the normal and abnormal neurological development of the fetus, and will facilitate more precise assessments of fetal neurobehavior or neurodevelopment, and fetal brain and central nervous system functions. In this review article, I also discuss interesting topics regarding maternal and fetal stress, fetal pain, and fetal consciousness. Four-dimensional ultrasound has opened the door to new scientific fields, such as 'fetal neurology' and 'fetal psychology,' and fetal neurobehavioral science is at the dawn of a new era. Knowledge on fetal neurobehavior and neurodevelopment will be advanced through fetal behavioral research using this technique.

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Section: Fetal Painmentioning

confidence: 99%

Current status of fetal neurodevelopmental assessment: Four‐dimensional ultrasound study

Hata

2016

J of Obstet and Gynaecol

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“…Neonatos pré-termo, assim como fetos por volta de 18 a 20 semanas de idade gestacional, já apresentam reações fisiológicas e comportamentais à dor e ao estresse (Anand & Whit Hall, 2007;Van de Velde, Jani, De Buck, & Deprest, 2006). Anteriormente, havia a concepção de que a reação à dor em neonatos pré-termo eram respostas reflexas que ocorriam no nível do tronco cerebral.…”

Section: O Contexto Inicial Do Desenvolvimento E a Dor Em Bebês Nasciunclassified

“…A exposição repetida à dor e ao estresse na UTIN pode alterar o substrato neurológico associado com o processamento de dor e, assim, levar a mudanças no processamento somatossensorial da dor e a respostas neurocomportamentais alteradas à dor (Simons & Tibboel, 2006;Van de Velde et al, 2006). O fenômeno de repetição do estímulo nocivo pode levar a: (a) hiperalgesia, reposta exagerada a um estímu-lo que permanece mesmo após cessar o estímulo nocivo original (Taddio, Shah, Atenafu, & Katz, 2009); (b) alodínia, reações de dor quando manuseado sem estímulo doloroso (Chimello, Gaspardo, Cugler, Martinez, & Linhares, 2009;Goubet, Clifton, & Shah, 2001); (c) aprendizagem por associação de estímulos e antecipação de eventos dolorosos (Chimello et al, 2009;Goubet et al, 2001).…”

Section: Consequências Da Exposição Precoce à Dor Para O Desenvolvimentounclassified

Dor, autorregulação e temperamento em recém-nascidos pré-termo de alto risco

Klein¹,

Gaspardo²,

Linhares³

2011

Psicol. Reflex. Crit.

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ResumoOs recém-nascidos pré-termo são expostos a experiências dolorosas inevitáveis na Unidade de Terapia Intensiva Neonatal. Apesar de sua imaturidade biológica, esses podem tanto perceber quanto reagir à dor. A exposição repetida à dor exerce impacto negativo no desenvolvimento e pode aumentar a vulnerabilidade dos bebês, dificultando os processos autorregulatórios. A reatividade biocomportamental à dor é um indicador de autorregulação e associa-se ao temperamento da criança. Esses bebês necessitam de estratégias farmacológicas e não farmacológicas para alívio da dor. Além disso, devem ter um contexto de interações sincrônicas com os pais, adaptadas às suas características de temperamento. Os profissionais de saúde podem atuar como suporte de regulação externa para esses bebês promovendo alívio da dor e prevenindo problemas de desenvolvimento. Palavras-chave: Dor; Nascimento Prematuro; Reatividade-estabilidade; Temperamento. AbstractHigh risk preterm newborns are exposed to unavoidable painful experiences in Neonatal Intensive Care Units. In spite of their biological immaturity, they are able to perceive and react to pain stimuli. Repetitive exposure to pain has a negative impact on the development and may increase the infant's vulnerability, affecting self-regulatory processes. Biobehavioral reactivity to pain is an indicator of self-regulation and it is associated to the child's temperament. Preterm infants need pharmacological and non-pharmacological strategies for pain relieving. Moreover, they need a context of synchronic interaction with their parents which must be adapted to their temperament characteristics. Health professionals may play an important role in supporting external regulation for those infants, promoting pain relief and preventing development problems.

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“…It starts at six weeks of pregnancy when the development and increase on number of sensory fibers and interneurons in the posterior horn of spinal cord occurs; during the seventh week of gestation, sensitive-cutaneous receptors are observed in the fetus' perioral area (4) . Not only anatomical development continues through the pregnancy, but the production of endogenous substances involved in the process of painful information also occurs.…”

Section: Introductionmentioning

confidence: 99%

“…The following can be highlighted: changes in metabolism and catabolism, energy expenditure to control pain instead of using energy reserves for growth and clinical reestablishment, future changes in behavioral, emotional, and cognitive aspects regarding subsequent painful episodes, changes in sensibility and anatomic structures (4,(8)(9) . Therefore, there is the need for pain control in neonatal units.…”

Section: Introductionmentioning

confidence: 99%

Evidências científicas no controle da dor no período neonatal

2009

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Objective: To critically analyze the systematic reviews on neonatal pain management published in the Cochrane library database. Methods: The keywords "pain" and "neonate" were used to search the database. Results: Six systematic reviews were retrieved. The main themes addressed by these systematic reviews were the following: pain related to therapeutic procedures (one review), non-pharmacological approaches for pain management (two reviews), and pharmacological approaches for pain management (three reviews). Conclusion: The systematic reviews suggested the need for other clinical studies with a larger sample size and a stronger research design. These studies would provide further evidence regarding the best approaches for adequate pain management in the neonatal population. Keywords: Pain/prevention & control; Infant, newborn; Evidence-based medicine RESUMOObjetivo: Identificar as revisões sistemáticas referentes ao controle da dor no neonato, catalogadas na Biblioteca Cochrane. Métodos: Utilizou-se os descritores pain e neonate. Resultados: Identificou-se seis publicações. Os temas abordados foram: dor resultante de procedimentos (uma revisão); métodos não-farmacológicos para o alívio da dor (duas) e métodos farmacológicos para analgesia (três). Conclusões: As revisões, de modo geral, apontam para a necessidade de condução de novos estudos clínicos, com amostras significativas e delineamentos adequados, para que mais evidências permitam instituir adequado controle da dor neonatal na prática clínica. Descritores: Dor/prevenção & controle; Recém-nascido; Medicina baseada em evidências RESUMEN Objetivo: Identificar las revisiones sistemáticas relacionadas con el control del dolor en el neonato, catalogadas en la Biblioteca Cochrane. Métodos: Se utilizaron las palabras clave pain y neonate. Resultados: Se identificaron seis publicaciones. Los temas abordados fueron: dolor resultante de procedimientos (una revisión); métodos no-farmacológicos para el alivio del dolor (dos) y métodos farmacológicos para analgesia (tres). Conclusiones: Las revisiones, de modo general, apuntan para la necesidad de conducir nuevos estudios clínicos, con muestras significativas y delineamientos adecuados, para que nuevas evidencias permitan instituir un adecuado control del dolor neonatal en la práctica clínica.

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Fetal pain perception and pain management

Cited by 49 publications

References 34 publications

Current status of fetal neurodevelopmental assessment: Four‐dimensional ultrasound study

Current status of fetal neurodevelopmental assessment: Four‐dimensional ultrasound study

Dor, autorregulação e temperamento em recém-nascidos pré-termo de alto risco

Evidências científicas no controle da dor no período neonatal

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