Prefrontal Cortical Near-Infrared Spectroscopy for Acute Pain Assessment in Infants: A Feasibility Study

Area of Science:

• Neuroscience
• Pediatrics
• Biomedical Engineering

Background:

• Infant pain assessment is challenging due to communication limitations.
• Untreated pain in infants can have long-term neurological effects.
• Accurate pain evaluation is critical for infant well-being.

Purpose of the Study:

• To investigate the utility of two-site near-infrared spectroscopy (NIRS) for assessing infant hemodynamic responses to pain.
• To correlate NIRS-derived prefrontal cortex oxygenation with behavioral pain scores.

Main Methods:

• Prospective data collection from ten infants undergoing heel lance/squeeze (HLS) post-surgery.
• Continuous bilateral NIRS monitoring of prefrontal cortex oxygenation.
• Concurrent assessment of cardiorespiratory parameters and the Children's and Infant's Postoperative Pain Score (CHIPPS).

Main Results:

• No significant prefrontal oxygenation changes were observed in the initial 10 seconds of HLS.
• Oxygenation levels remained stable despite increases in CHIPPS and heart rate during HLS.
• Inverse correlations were found between lowest oxygenation levels and CHIPPS/HR changes in specific hemispheres.

Conclusions:

• Conventional two-site NIRS may be insufficient for detecting acute pain in infants.
• Subtle NIRS signal alterations were inconclusive for pain assessment.
• Future studies should explore multi-modal approaches including fNIRS, fMRI, EEG, and autonomic indicators for robust infant pain quantification.