Therapeutic Studies & Psychology
Does the neonatal clinical risk for illness severity influence pain reactivity and recovery in preterm infants?
Article first published online: 19 DEC 2011
© 2011 European Federation of International Association for the Study of Pain Chapters
European Journal of Pain
Volume 16, Issue 5, pages 727–736, May 2012
How to Cite
Valeri, B.O., Gaspardo, C.M., Martinez, F.E. and Linhares, M.B.M. (2012), Does the neonatal clinical risk for illness severity influence pain reactivity and recovery in preterm infants?. European Journal of Pain, 16: 727–736. doi: 10.1002/j.1532-2149.2011.00037.x
This study was supported by the Foundation for Support of Research in the State of São Paulo, Brazil (FAPESP), the National Council for Development Science and Technology (CNPq).
Conflicts of interest
- Issue published online: 2 APR 2012
- Article first published online: 19 DEC 2011
- Manuscript Accepted: 28 OCT 2011
- State of São Paulo, Brazil (FAPESP)
- National Council for Development Science and Technology (CNPq)
The biobehavioural pain reactivity and recovery of preterm infants in the neonatal period may reflect the capacity of the central nervous system to regulate neurobiological development.
The aim of the present study was to analyse the influence of the neonatal clinical risk for illness severity on biobehavioural pain reactivity in preterm infants.
Fifty-two preterm infants were allocated into two groups according to neonatal severity of illness, as measured by the Clinical Risk Index for Babies (CRIB). The low clinical risk (LCr) group included 30 neonates with CRIB scores <4, and the high clinical risk (HCr) group included 22 neonates with CRIB scores ≥4. Pain reactivity was assessed during a blood collection, which was divided into five phases (baseline, antisepsis, puncture, recovery-dressing and recovery-resting). Behavioral pain reactivity was measured using the scores, and magnitude of responses in Neonatal Facial Coding System (NFCS) and Sleep-Wake States Scale (SWS). The heart rate was continuously recorded.
The HCr demonstrated a higher magnitude of response on the SWS score from the baseline to the puncture phase than the LCr. Also, the HCr exhibited a higher mean heart rate and minimum heart rate than the LCr in the recovery-resting phase. In addition, the HCr exhibited a higher minimum heart rate from the baseline to the recovery-resting phase than the LCr.
The infants exhibiting a high neonatal clinical risk showed high arousal during the puncture procedure and higher physiological reactivity in the recovery phase.