Biobehavioral Pain Responses in Former Extremely Low Birth Weight Infants at Four Months' Corrected Age

Oberlander, Tim F.; Grunau, Ruth E.; Whitfield, Michael F.; Fitzgerald, Colleen; Pitfield, Alexander F.; Saul, J. Philip

doi:10.1542/peds.105.1.e6

Cited by 133 publications

(87 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The prevention of pain is important not only because it is an ethical expectation but also because repeated painful exposures can have deleterious consequences. [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21] These consequences include altered pain sensitivity 5,[7][8][9] (which may last into adolescence 15 ) and permanent neuroanatomic and behavioral abnormalities, as found in animal studies. 5,14 It seems that altered pain sensitivity can be ameliorated if effective pain relief is provided.…”

Section: Introductionmentioning

confidence: 99%

Prevention and Management of Pain in the Neonate: An Update

2006

Pediatrics

420

View full text Add to dashboard Cite

The prevention of pain in neonates should be the goal of all caregivers, because repeated painful exposures have the potential for deleterious consequences. Neonates at greatest risk of neurodevelopmental impairment as a result of preterm birth (ie, the smallest and sickest) are also those most likely to be exposed to the greatest number of painful stimuli in the NICU. Although there are major gaps in our knowledge regarding the most effective way to prevent and relieve pain in neonates, proven and safe therapies are currently underused for routine minor yet painful procedures. Every health care facility caring for neonates should implement an effective pain-prevention program, which includes strategies for routinely assessing pain, minimizing the number of painful procedures performed, effectively using pharmacologic and nonpharmacologic therapies for the prevention of pain associated with routine minor procedures, and eliminating pain associated with surgery and other major procedures. INTRODUCTION ObjectivesThis updated statement is intended for health care professionals who care for neonates (preterm to 1 month of age). The objectives are to:1. emphasize that despite increased awareness of the importance of pain prevention, neonates in the NICU continue to be exposed to numerous painful minor procedures daily as part of their routine care;2. present objective means of assessing neonatal pain by health care professionals;3. describe effective strategies to prevent and treat pain associated with routine minor procedures; and 4. review appropriate methods to prevent and treat pain associated with surgery and other major procedures. BackgroundThe prevention of pain in neonates is an expectation of parents. 1 However, there are major gaps in our knowledge regarding the most effective way to accomplish this. Although it may not be possible to completely eliminate pain in neonates, much can be done to reduce the amount and intensity of pain. The prevention of www.pediatrics.org/cgi

show abstract

Section: Introductionmentioning

confidence: 99%

Prevention and Management of Pain in the Neonate: An Update

2006

Pediatrics

420

View full text Add to dashboard Cite

show abstract

“…Stress induced analgesia may also be observed in large trauma victims. In rats it has been found that c-fos expression diminishes when a painful stimulus is applied during stressful conditions (Magalhães 2003) There are some suppositions that repeated stimuli in the same place may develop altered disseminated responses during pain perception (Oberlander et al 2000, Gibson 2004, Camozzatto et al 2009). …”

Section: Discussionmentioning

confidence: 99%

Interference of age and repetition of the same noxious stimulus on hyperalgesia

2010

View full text Add to dashboard Cite

“…NFCS [16] was used to measure infants' facial responses to acute pain. Based on the use of NFCS in previous work [11,25,27] The original NFCS study [16] provided evidence of adequate psychometric properties.…”

Section: Infant Behavioural Pain Measuresmentioning

confidence: 99%

“…In preverbal infants, clinicians and researchers are wholly dependent on proxy judgments by benevolent adult caregivers, posing challenges with notable drawbacks [25,29]. To 'hear' the voice of the infant we must use behavioural measures.…”

Section: Introductionmentioning

confidence: 99%

Infant Clinical Pain Assessment: Core Behavioral Cues

DiLorenzo

Riddell

Flora

et al. 2018

The Journal of Pain

View full text Add to dashboard Cite

2 Highlights NFCS and MBPS coding systems were examined using Confirmatory Factor Analysis.  A revised 3-item NFCS maintained good psychometric properties of 7-item version.  Redefinition of MBPS with cry as a sole indicator was suggested.  The revised scales increase efficiency of coding based on improved psychometrics. AbstractDiverse behavioural cues have been proposed to be useful cues in infant pain assessment, but there is a paucity of evidence based on formal psychometric evaluation to establish their validity for this purpose. We aimed to examine two widely-used coding systems, the Neonatal Facial Coding System (NFCS) and the Modified Behaviour Pain Scale (MBPS), by examining their factor structures with confirmatory factor analysis using a large archival dataset. The results indicated that an item-reduced NFCS scale with three items produced a one-factor pain model that maintained the good psychometric properties of the 7-item scale. In addition, it was found that MBPS also has challenging internal consistency, with items that are both weakly correlated and highly redundant. One-item of the MBPS may be able to capture the construct of pain equally well or potentially improve its psychometric properties. Redefinition of MBPS with cry as a sole indicator was suggested. This analysis provides two new iterations of the NFCS and MBPS that improve construct validity and internal consistency. These shorter versions also improve the feasibility of both measures and increase their potential for clinical use as less time is required for their administration.Perspective: This article presents new iterations of the NFCS and MBPS scales. These revised measures improve the internal consistency of the measures, feasibility of use of the tools in research settings and the efficiency of the coding process. The revised tools could also improve the feasibility of coding within clinical settings.

show abstract

Biobehavioral Pain Responses in Former Extremely Low Birth Weight Infants at Four Months' Corrected Age

Cited by 133 publications

References 27 publications

Prevention and Management of Pain in the Neonate: An Update

Prevention and Management of Pain in the Neonate: An Update

Interference of age and repetition of the same noxious stimulus on hyperalgesia

Infant Clinical Pain Assessment: Core Behavioral Cues

Contact Info

Product

Resources

About