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Development of pain mechanisms
1Department of Anatomy & Developmental Biology, University College London, UK.
Insights
Newborn infants, especially premature ones, experience pain during intensive care procedures. Current beliefs about infant pain perception are outdated and based on fear, necessitating better pain management strategies.
Area of Science:
- Neonatal neuroscience
- Pain perception research
- Pediatric anesthesiology
Background:
- Increasing survival rates of premature infants (under 1000 gm) lead to more neonates undergoing traumatic procedures in intensive care units.
- A significant number of these vulnerable infants require surgical interventions, increasing their exposure to painful stimuli.
- Traditional pediatric and anesthesiology practices often neglect pain management in newborns due to misconceptions and fear.
Purpose of the Study:
- To highlight the growing interest in the neural development of pain pathways in infants.
- To address the critical need for improved pain perception and treatment protocols for newborn infants.
- To challenge outdated beliefs regarding neonatal pain and memory.
Main Methods:
- Review of current literature on neonatal pain pathways.
- Analysis of clinical practices in intensive care units concerning infant pain.
- Examination of historical misconceptions in pediatric pain management.
Main Results:
- Neonatal pain pathways are developing, and infants are capable of feeling pain.
- Improved survival rates in neonatal intensive care units (NICUs) result in more infants experiencing significant pain.
- Established beliefs about newborns not feeling or remembering pain are being disproven.
Conclusions:
- Newborn infants, including premature ones, demonstrably feel and remember pain.
- The practice of withholding anesthesia and analgesia from newborns is based on flawed reasoning.
- There is an urgent need to update clinical practices to ensure adequate pain management for all infants.
Abstract:
Interest in the neural development of pain pathways and of the perception and treatment of pain in newborn infants has increased markedly in the last few years. The tremendous improvement in the survival of premature infants, particularly those weighing less than 1000 gm at birth, means that there are now a significant number of infants, many of whom require surgery, undergoing necessarily extensive traumatic procedures in intensive care units. At the same time it is becoming clear that the traditional belief of paediatricians and anaesthetists that newborn infants do not feel or remember pain and therefore need no anaesthesia or analgesia is rooted in a mixture of misconception and fear.