Maturational changes in physiologic and behavioral responses of preterm neonates to pain.

PURPOSE: To identify physiologic and behavioral responses of preterm infants to a routinely administered painful stimulus (heelstick) to determine how postconceptional age (PCA) may influence pain responses.SUBJECTS: Nonprobability convenience sample of I I preterm infants born at 24-26 weeks PCA.DE...

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Published in:Advances in Neonatal Care (Elsevier Science) Vol. 1; no. 2; pp. 94 - 107
Main Authors: Walden M, Penticuff JH, Stevens B, Lotas MJ, Kozinetz CA, Clark A, Avant KC
Format: research tables/charts Journal Article
Published: Elsevier B.V. 2001 Dec
Online Access:View this record in EBSCOhost
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      jtl: Advances in Neonatal Care (Elsevier Science)
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      dt: 2001 Dec
      vid: 1
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      pub: Elsevier B.V.
      place: New York, New York
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        atl: Maturational changes in physiologic and behavioral responses of preterm neonates to pain.
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        au:
          Walden M
          Penticuff JH
          Stevens B
          Lotas MJ
          Kozinetz CA
          Clark A
          Avant KC
        affil: Department of Pediatrics, Baylor College of Medicine, Houston, TX; MWaldenNNP@aol.com
      sug:
        subj:
          Infant Behavior
          Infant, Premature
          Treatment Related Pain Physiopathology
          Age Factors
          Behavior Rating Scales
          Blood Specimen Collection Adverse Effects
          Clinical Assessment Tools
          Convenience Sample
          Data Analysis Software
          Descriptive Statistics
          Friedman Test
          Funding Source
          Gestational Age
          Heart Rate In Infancy and Childhood
          Heel In Infancy and Childhood
          Infant, Newborn
          Intensive Care Units, Neonatal
          Interrater Reliability
          McNemar's Test
          Oxygen Saturation In Infancy and Childhood
          Pain Measurement In Infancy and Childhood
          Post Hoc Analysis
          Quasi-Experimental Studies
          Reliability
          Repeated Measures
          Research Instruments
          Respiratory Rate In Infancy and Childhood
          Sample Size
          Southwestern United States
          Validity
          Wilcoxon Signed Rank Test
          Human
          Infant, Newborn: birth-1 month
      ab: PURPOSE: To identify physiologic and behavioral responses of preterm infants to a routinely administered painful stimulus (heelstick) to determine how postconceptional age (PCA) may influence pain responses.SUBJECTS: Nonprobability convenience sample of I I preterm infants born at 24-26 weeks PCA.DESIGN: Quasi-experimental, repeated measures design.METHODS: The Neonatal Individualized Developmental Care Assessment Program (NIDCAP) method was used to assess infant responses before, during, and after a heelstick performed at weekly intervals between ages 27-32 weeks PCA.MAIN OUTCOME MEASURES: Univariate indicators of pain, including physiologic (heart rate, oxygen saturation, and respiratory rate) and behavioral (brow bulge, eye squeeze, and 4S NIDCAP variables) responses, were examined. Additionally, the Premature Infant Pain Profle (PIPP) was used as a composite measure to assess pain.PRINCIPAL RESULTS: Heart rate increased, whereas oxygen saturation and respiratory rate decreased during the most invasive phase of the procedure for infants between 27-32 weeks PCA. Increased PIPP scores and increased brow bulge and eye squeeze were also noted during the stick/squeeze phase. Finger splay increased significantly in magnitude of occurrence between 27-32 weeks PCA, whereas other NIDCAP variables, physiologic measures, facial variables, and PIPP scores were not sensitive to differences in PCA.CONCLUSIONS: Former 24- to 26-week preterm infants who are between 27-32 weeks PCA are capable of expressing pain through physiologic measures and facial actions in a manner similar to more mature preterm and healthy term infants. The PIPP is a valid instrument for assessing pain in infants as young as 27-32 weeks PCA.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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