Pain Assessment in Neonates

Pain Assessment in Neonates

Hanne Storm
Copyright: © 2012 |Pages: 25
DOI: 10.4018/978-1-4666-0975-4.ch013
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Abstract

In the U.S. it is mandatory to assess and treat pain. Italy, France, and Russia are establishing standards that mean pain assessment and treatment may become mandatory. Physiological, behavioural, and biochemical tools have been used for pain assessment but no gold standard is yet available. These tools have both limits and benefits. The topic of this chapter is to discuss these tools for different infant groups and to conclude if they can fulfill a gold standard for pain assessment. This gold standard should be independent of the infant’s level of maturity and level of illness, should give accurate pain measurement, be in real time, give an immediate response, and the index should be valid for all infants.
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Assessment Of Acute Or Chronic Pain?

The tools that are available to assess pain in infants mainly focus on acute pain, a specific nociceptive event that is self-limited (American Pain Society, http://www.ampainsoc.org/). Examination of behavioural changes such as facial expression, body movement, flexion reflex, cry, and/or physiological indicators such as heart rate, respiratory rate, blood pressure, oxygen saturation, and palmar sweating, are the basis for acute pain assessment scores. Duhn and Medeves published a systematic review including a huge number of univariate, multivariate and composite measures for assessing acute pain in infants (2004). This focus on developing such tools underscores the demand for a gold standard for pain management. In infants, physiological, bio-chemical and/or behavioural indicators are surrogates for self-reporting of pain.

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