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[Behavioral pain scales assessment in neonates]
R Guinsburg1, R de C Balda, R C Berenguel
1Disciplina de Pediatria Neonatal, Universidade Federal de São Paulo, São Paulo, SP.
Jornal De Pediatria
|December 20, 2003
Summary
The Neonatal Facial Action Coding System (NFCS) and Neonatal Infant Pain Scale (NIPS) effectively assess pain in premature infants. NFCS demonstrated higher sensitivity and specificity compared to NIPS for pain detection.
Area of Science:
- Neonatal care
- Pain assessment
- Pediatric research
Background:
- Accurate pain assessment in neonates is crucial for appropriate clinical management.
- Behavioral pain scales are vital tools for evaluating pain in non-verbal infants.
- Gestational age influences pain perception and response in newborns.
Purpose of the Study:
- To determine the sensitivity and specificity of the Neonatal Facial Action Coding System (NFCS) and Neonatal Infant Pain Scale (NIPS).
- To compare the efficacy of NFCS and NIPS in neonates across different gestational ages (GA).
Main Methods:
- 133 clinically stable neonates were assessed using NFCS and NIPS during capillary puncture or alcohol swab procedures.
- Neonates were categorized by gestational age: 28-33 weeks (Group A), 34-37 weeks (Group B), and 38-41 weeks (Group C).
- Pain scores were evaluated before, during, and after procedures, with and without foot warming, by a blinded neonatologist.
Main Results:
- Both NFCS and NIPS scores were significantly higher during procedures for capillary puncture compared to alcohol swabs across all gestational age groups.
- NFCS demonstrated higher sensitivity (88-91%) and specificity (80-84%) compared to NIPS (77-87% sensitivity, 68-83% specificity) during procedures.
- Pain scores assessed by NFCS and NIPS were generally consistent across different gestational ages for the capillary puncture group.
Conclusions:
- Both NFCS and NIPS are reliable tools for assessing procedural pain in premature infants.
- The Neonatal Facial Action Coding System (NFCS) appears to be a more sensitive and specific measure of pain than the Neonatal Infant Pain Scale (NIPS) in this population.