Does the neonatal clinical risk for illness severity influence pain reactivity and recovery in preterm infants?

Abstract

The infants exhibiting a high neonatal clinical risk showed high arousal during the puncture procedure and higher physiological reactivity in the recovery phase.

Non-pharmacological management of neonatal pain: Research and clinical practice in the Neonatal Intensive Care Unit

“…Pain is under-notified, not systematically assessed through validated instruments, poorly documented in medical charts, and, consequently, undertreated, in both developed (Stevens et al, 2011;Taylor, Boyer, & Campbell, 2008) and developing countries (Linhares et al, 2012). The prevalence, assessment, and management of pediatric pain was examined in a Brazilian public teaching hospital, with the findings providing evidence of the high prevalence of pain in pediatric inpatients and the under-recognition of pain by health professionals (Linhares et al, 2012). In this Brazilian audit study, with 34 children/adolescents interviewed, 59% reported pain, 68% of whom reported that they received pharmacological intervention for pain relief.…”

“…The clinical health status of the newborn is directly associated with gestational age and birth weight, with increased lengths of stay in NICU related to more painful procedures in the neonatal pain history (Goffaux et al, 2008;Valeri, Gaspardo, Martinez, & Linhares, 2012;Williams, Ktattak, Garza, & Lasky, 2009). The inpatients of the NICU are mainly preterm and very low birth weight newborns with clinical diseases associated, such as intracranial hemorrhage, bronchopulmonary dysplasia, and/or retinopathy of prematurity.…”

“…Preterm infants with increased severity of illness have shown greater arousal during puncture and higher physiological reactivity after a puncture than clinically stable preterm infants (Valeri et al, 2012). Usually, preterm infants spend an average of two months in a NICU setting (Linhares, Gaspardo, Souza, Valeri, & Martinez, 2014), characterizing a toxic stress experience during early development.…”

Examining the side effects of sucrose for pain relief in preterm infants: a case-control study

“…Preterm neonates show cortical (1,2), biochemical (3), physiological (4,5), and behavioral (6,7) responses to painful procedures. Nonpharmacological management has been recommended for pain relief, such as nonnutritive sucking (8), breastfeeding (9,10), skin-to-skin contact (11,12), and sweetened solutions, including glucose (13), fructose (14), and sucrose (15-19).…”

Indicadores de temperamento e comportamento em crianças nascidas pré-termo em comparação a crianças nascidas a termo, na fase de 18 a 36 meses de idade

“…Assim, o desenvolvimento inicial do bebê nascido pré-termo pode sofrer impactos negativos decorrentes dos fatores que caracterizam a UTIN como um ambiente estressor, a saber: procedimentos invasivos e dolorosos (Valeri, Holsti, & Linhares, 2015), sons altos (Lahav & Skoe, 2014), alta luminosidade (Morag & Ohlsson, 2016), multiplicidade de estímulos táteis (Gaspardo, Chimello, Cugler, Martinez, & Linhares, 2008), e separação da mãe (Mooney-Leber & Brummelte, 2017). O estado clínico do recém-nascido é diretamente associado à idade gestacional e peso ao nascer, com o aumento do tempo de internação na UTIN e a procedimentos mais dolorosos na história de dor neonatal (Goffaux et al, 2008;Valeri, Gaspardo, Martinez e Linhares, 2012;Williams, Ktattak, Garza, & Lasky, 2009). O desenvolvimento inicial e posterior da criança nascida prétermo pode sofrer danos em decorrência dessa experiência inicial de dor e estresse neonatal (Grunau, 2013;Valeri et al, 2015).…”