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Trajectories of post-surgical pain in infants admitted to neonatal intensive care

Emre Ilhan1, Claire Galea2,3, Verity Pacey1,4

  • 1Department of Health Professions, Faculty of Medicine, Human and Health Sciences, Macquarie University, Sydney, NSW, Australia.

European Journal of Pain (London, England)
|July 14, 2020
PubMed

Insights

Infants undergoing surgery show two pain recovery paths: a typical one within days and an atypical one lasting weeks or months, resembling chronic pain. This study identified these distinct post-surgical pain trajectories in infants.

Area of Science:

  • Pediatric Surgery
  • Pain Management
  • Neonatal Care

Background:

  • Post-surgical pain in infants is a significant concern.
  • Understanding pain recovery trajectories is crucial for effective management.
  • Neonatal intensive care units (NICUs) often manage infants with complex post-surgical pain needs.

Purpose of the Study:

  • To statistically identify distinct pain trajectories in infants under six months of age following surgery.
  • To compare identified pain trajectories with established descriptions of chronic pain in NICU infants.

Main Methods:

  • Retrospective review of medical records for 726 infants admitted to a NICU post-surgery (2008-2018).
  • Inclusion criteria: infants who underwent one major abdominal or thoracic procedure.
  • Group-based trajectory analysis applied to pain data assessed using a validated Pain Assessment Tool.

Main Results:

  • Two distinct pain trajectories were identified: typical (n=467) and atypical (n=259).
  • The typical group experienced significantly fewer days and instances of pain compared to the atypical group.
  • The atypical group showed a higher incidence of iatrogenic neonatal abstinence syndrome (11% vs 5%).

Conclusions:

  • Two distinct post-surgical pain trajectories exist in infants.
  • The atypical trajectory, characterized by prolonged pain (weeks/months), aligns with definitions of chronic pain in infants.
  • This finding highlights the need for tailored pain management strategies for infants with atypical recovery patterns.
Abstract

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