Assessing Pain in Preterm Infants in the Neonatal Intensive Care Unit: Moving to a ‘Brain-Oriented‘ Approach

Abstract

Summary Preterm infants in the neonatal intensive care unit undergo repeated exposure to procedural and ongoing pain. Early and long-term changes in pain processing, stress-response systems and development may result from cumulative early pain exposure. So that appropriate treatment can be given, accurate assessment of pain is vital, but is also complex because these infants‘ responses may differ from those of full-term infants. A variety of uni- and multidimensional assessment tools are available; however, many have incomplete psychometric testing and may not incorporate developmentally important cues. Near-infrared spectroscopy and/or EEG techniques that measure neonatal pain responses at a cortical level offer new opportunities to validate neonatal pain assessment tools.

Acknowledgements

The authors would like to thank Elizabeth Norman, Department of Pediatrics, Lund University Hospital (Sweden) for providing helpful comments on an earlier version of this manuscript.

Financial & competing interests disclosure

RE Grunau‘s research program is supported by operating grants from the Eunice Kennedy Shriver National Institute of Child Health and Human Development, Canadian Institutes of Health Research, and a salary award from the Child and Family Research Institute. L Holsti‘s research program is supported by a Tier II Canada Research Chair in Neonatal Health and Development, and the Child and Family Research Institute. E Shany‘s research is supported by the Goldman Faculty Fund for the Young Researchers of the Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.

Additional information

Funding

RE Grunau‘s research program is supported by operating grants from the Eunice Kennedy Shriver National Institute of Child Health and Human Development, Canadian Institutes of Health Research, and a salary award from the Child and Family Research Institute. L Holsti‘s research program is supported by a Tier II Canada Research Chair in Neonatal Health and Development, and the Child and Family Research Institute. E Shany‘s research is supported by the Goldman Faculty Fund for the Young Researchers of the Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.