Multidimensional pain assessment in premature neonates: a pilot study
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B J Stevens1, C C Johnston, L Horton
1Faculty of Nursing, University of Toronto, Ontario, Canada.
Objective:
To describe the physiologic and behavioral responses of premature neonates to a painful stimulus.
Design:
Descriptive.
Setting:
Secondary-level neonatal unit in a large metropolitan university teaching hospital.
Participants:
Forty neonates between 32 and 34 weeks' postconceptual age and less than 5 days' postnatal age.
Main Outcome Measures:
Physiologic (heart rate, oxygen saturation, and intracranial pressure) and behavioral (facial expression and cry) outcomes observed during a routine heel stick.
Results:
Physiologic responses were significant, but were not specific to pain. Behavioral responses were more promising and indicated that premature neonates were capable of responding in a manner similar to full-term neonates.
Conclusions:
Premature neonates are capable of expressing their pain in a manner similar to healthy, full-term neonates. Factors that alter this response were not clearly delineated. Further research is needed to determine more precise patterns of response in this age group.