Differences in pain expression between male and female newborn infants

Guinsburg, Ruth; Peres, C.; Almeida, Maria Fernanda Branco de; Balda, Rita de Cássia Xavier; Berenguel, Rosevânia C.; Tonelotto, Jaqueline; Kopelman, Benjamin Israel

doi:10.1016/s0304-3959(99)00258-4

Cited by 120 publications

(40 citation statements)

References 24 publications

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“…Divergences could be linked to factors related to the characteristics of the neonates themselves or of the healthcare professionals working there. 7,10,[13][14][15][16][17] Fentanyl (93%) was the most prescribed analgesic in this study, in a similar manner to what has been reported by Anand and Selanikio 18 and Castro et al. 8 In contrast, Stevens et al 19 found that morphine was given twice as often as fentanyl at Canadian neonatal units.…”

Section: Discussionsupporting

confidence: 79%

Freqüência do emprego de analgésicos em unidades de terapia intensiva neonatal universitárias

Prestes¹,

Guinsburg²,

Balda³

et al. 2005

J. Pediatr. (Rio J.)

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Objective: To evaluate the use of drugs to relieve the pain of invasive procedures newborn infants cared for at a university hospital NICU.Methods: A prospective cohort study of all newborn infants hospitalized in four NICU during October 2001. The following data were collected: demographic data of the hospitalized newborn infants; clinical morbidity; number of potentially painful procedures and frequency of analgesic administration. Factors associated with the use of analgesia in this cohort of patients were studied by multiple linear regression using SPSS 8.0.Results: Ninety-one newborn infants were admitted to the NICU during the study period (1,025 patient-days). Only 25% of the 1,025 patient-days received systemic analgesia. No specific drugs were administered to relieve acute pain during any of the following painful events: arterial punctures, venous, capillary and lumbar punctures or intubations. For chest tube insertion, 100% of newborn infants received specific analgesia. For the insertion of central catheters 8% of the newborn infants received painkillers. Only nine of the 17 newborn infants that underwent surgical procedures received any analgesic dosage during the postoperative period. For 93% of patients under analgesia the drug of choice was fentanyl. The presence of mechanical ventilation increased the chance of newborn infants receiving painkillers by 6.9 times and the presence of chest tube increased this chance by five times. Conclusion:It is necessary to train health professionals in order to bridge the gap between scientific knowledge regarding newborn infant pain and clinical practice.

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Section: Discussionsupporting

confidence: 79%

Freqüência do emprego de analgésicos em unidades de terapia intensiva neonatal universitárias

Prestes¹,

Guinsburg²,

Balda³

et al. 2005

J. Pediatr. (Rio J.)

Self Cite

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“…A few studies suggest that sex differences in pain/analgesia develop by the early neonatal period in the rodent [37,110,192], although it is not clear whether sex differences are observed that early in humans [65,80,152]. In contrast, beginning around puberty, age-dependent sex differences occur for several types of pain in humans.…”

Section: How Does Pain Chronicity Contribute To Sex Differences In Pamentioning

confidence: 99%

Studying sex and gender differences in pain and analgesia: A consensus report

Greenspan

Craft

LeResche

et al. 2007

Pain

871

633

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In September 2006, members of the Sex, Gender and Pain Special Interest Group of the International Association for the Study of Pain met to discuss the following: (1) what is known about sex and gender differences in pain and analgesia; (2) what are the "best practice" guidelines for pain research with respect to sex and gender; and (3) what are the crucial questions to address in the near future? The resulting consensus presented herein includes input from basic science, clinical and psychosocial pain researchers, as well as from recognized experts in sexual differentiation and reproductive endocrinology. We intend this document to serve as a utilitarian and thought-provoking guide for future research on sex and gender differences in pain and analgesia, both for those currently working in this field as well as those still wondering, "Do I really need to study females?" Keywords Sex differences; Gonadal hormones; Estrogens The case for studying sex and gender differences in pain and analgesiaThe pain field has moved from debating whether sex differences in pain exist to recognizing the importance of these differences. Attention is now directed toward understanding (1) what conditions lead to the expression of sex and gender differences in pain experience and reactivity, (2) what mechanisms underlie these differences, and (3) how these differences can inform clinical management of pain.As noted in a recent review, at least 79% of animal studies published in Pain over the preceding 10 years included male subjects only, with a mere 8% of studies on females only, and another 4% explicitly designed to test for sex differences (the rest did not specify) [142]. Given the substantially greater prevalence of many clinical pain conditions in women vs. men [20,199], and growing evidence for sex differences in sensitivity to experimental pain and to analgesics [21,41,213], we recommend that all pain researchers consider testing their hypotheses in both sexes, or if restricted by practical considerations, only in females. It is invalid to assume that data obtained in male subjects will generalize to females, and the best non-human model of the modal human pain sufferer -a woman -is a female animal. If only males are examined in a given study, it is important that a rationale for exclusion of females be provided and that the potential limitation in generalizability of the findings be addressed in the discussion, particularly when examining a pain phenomenon that occurs with greater prevalence or severity in females. In both preclinical and clinical studies, a comparison of both sexes will further our understanding of individual differences in sensitivity to pain and analgesia, thus improving our ability to treat and prevent pain in all people. General considerationsTwo issues of terminology are important. First, the term "sex" refers to biologically based differences, while the term "gender" refers to socially based phenomena. Although biological sex exerts a major influence on one's gender identity, sex and gender a...

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“…Recent experimental studies have addressed these sex differences in behavioral expression after early postnatal noxious stimulation Murphy, 2007, 2010;Negrigo et al, 2011) and sex-specific behavioral alterations between preterm and agematched infants (Guinsburg et al, 2000).…”

Section: Introductionmentioning

confidence: 99%