Response to pain in a group of healthy term newborns: behavioral and physiological aspects

Various reports have documented the difficulty in assessing neonatal response to painful stimuli. The aim of our study was to evaluate previously described scales for assessing pain in a group of 18 healthy term newborns selected according to Prechtl's optimality criteria and subjected to a routine metabolic screening blood test performed on the 5th day of life. Both a modified CHEOPS scale and Grunau-Craig Scale, to assess pain behavior response before, during and after a painful stimulus, revealed definite modifications in scores. Response to pain was also evaluated by measuring variations in decreases in transcutaneous oxygen pressure in all newborns during application of the stimulus and in returns to baseline or higher values upon removal of the stimulus. Our study confirms that healthy term newborns feel pain when subjected to limited painful stimuli such as the routine blood test and suggests useful and easy methodological tools to evaluate pain in the newborn.