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Updated: May 25, 2026
Electrophysiological Measurements and Analysis of Nociception in Human Infants
Published on: December 20, 2011
Physiological measures of assessing infant pain: a literature review
1Neonatal Intensive Care Unit, Greater Glasgow and Clyde, Royal Hospital for Sick Children, Yorkhill, Southern General Hospital, Glasgow.
Insights
Neonatal pain assessment lacks standardization. While physiological measures like heart rate can indicate pain, a multidimensional approach combining behavioral and physiological indicators is most effective for neonates.
Area of Science:
- Neonatal care
- Pain management
- Physiology
Background:
- Standardized neonatal pain assessment is lacking, leading to varied clinical interpretations.
- There is no validated biological marker for infant pain assessment.
- Physiological parameters offer a feasible method for pain assessment in non-verbal neonates.
Purpose of the Study:
- To systematically review literature on physiological measures for neonatal pain assessment.
- To evaluate the utility of various physiological parameters in quantifying infant pain.
Main Methods:
- A systematic literature review using qualitative methods was conducted.
- Seven research papers utilizing physiological measures for neonatal pain assessment were selected.
Main Results:
- Heart rate was the most frequently used physiological indicator of pain in neonates.
- Oxygen saturation, blood pressure, and respiratory rate showed limited sensitivity and specificity for independent use.
- These physiological measures can detect pain but not quantify it, limiting their utility for chronic pain assessment.
Conclusions:
- A multidimensional approach to neonatal pain assessment is recommended.
- The correlation between behavioral and physiological indicators supports a comprehensive assessment strategy.
Abstract:
Neonatal pain assessment is not standardized. Clinicians may use various parameters in the measurement of pain which can lead to different interpretations. Currently, there is no validated biological marker for assessing infant pain in any age group. However, in the non-verbal patient, the most feasible way to assess pain may be by evaluation of physiological parameters. The author conducted a systematic review of the literature using qualitative methods and seven research papers were selected for review, in which physiological measures were used in the assessment of neonatal pain. Heart rate was the most frequently used physiological pain measure in these studies. Oxygen saturation, blood pressure and respiratory rate lacked sensitivity and specificity and cannot be used independently. These measures may detect pain but cannot quantify it and are, therefore, not useful assessments of chronic pain. The multidimensional approach to pain assessment may be the most appropriate owing to the correlation between behavioural and physiological indicators of pain in the neonate.
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