Clinical assessment of pain in newborns
A. V. Andreev,
N. V. Kharlamova,
S. S. Mezhinskiy,
N. A. Shylova,
A. L. Karpova,
А. V. Mostovoy,
A. A. Pesenkina https://doi.org/10.21508/1027-4065-2020-65-4-5-15
Abstract
Theе article describes the key points of pain assessment in newborns, its prognostic value, and tools to assess the pain severity in a child unable to inform about the problem. The latter is of special interest, since the results of existing scientific research in the neonatal practice are not completely universal and clear. The review contains data on pain in newborns available in open sources. The authors devoted special attention to clinical methods of pain severity determination, especially to the most widely used scales. They compared the clinical methods for objectifying the pain severity in newborns frequently used in neonatal practice.
Supporting agencies: Andreev A.V. receives financial support from the RFBR in the framework of scientific project No. 19-31-27001
About the Authors
A. V. Andreev
Gorodkov Ivanovo Research Institute of Maternity and Childhood
Russian Federation
Russian Federation
N. V. Kharlamova
Gorodkov Ivanovo Research Institute of Maternity and Childhood
Russian Federation
Russian Federation
S. S. Mezhinskiy
Gorodkov Ivanovo Research Institute of Maternity and Childhood
Russian Federation
Russian Federation
N. A. Shylova
Gorodkov Ivanovo Research Institute of Maternity and Childhood
Russian Federation
Russian Federation
A. L. Karpova
Kaluga Regional Clinical Hospital
Russian Federation
Russian Federation
А. V. Mostovoy
Kaluga Regional Clinical Hospital
Russian Federation
Russian Federation
A. A. Pesenkina
Gorodkov Ivanovo Research Institute of Maternity and Childhood
Russian Federation
Russian Federation
References
1. Committee on Fetus and Newborn and Section on Anesthesiology and Pain Medicine Prevention and management of procedural pain in the neonate: an update. Pediatrics 2016; 137(2): e20154271. DOI: https://doi.org/10.1542/peds.2015-4271
2. Brummelte S., Grunau R.E., Chau V., Poskitt K.J., Brant R, Vinall J. et al. Procedural pain and brain development in premature newborns. Ann Neurol 2012; 71(3): 385—396. DOI: 10.1002/ana.22267
3. Harris J., Ramelet A.S., van Dijk M., Pokorna P., Wielenga J., Tume L. et al. Clinical recommendations for pain, sedation, withdrawal and delirium assessment in critically ill infants and children: an ESPNIC position statement for healthcare professionals. Intensive Care Med 2016; 42(6): 972—986. DOI: 10.1007/s00134-016-4344-1
4. Stevens B.J., Pillai R.R., Oberlander T.F., Gibbins S. Assessment of pain in neonates and infants. In: K.J. Anand, B.J. Stevens, P.J. McGrath (eds). Pain in neonates and infants. New York: Elsevier, 2007; 67—86.
5. Pillai R.R., Stevens B.J., McKeever P., Gibbins S., Asztalos L, Katz J. et al. Chronic pain in hospitalized infants: health professionals’ perspectives. J Pain 2009; 10: 1217—1225. DOI 10.1016/j.jpain.2009.04.013
6. Ambuel B., Hamlett K.W., Marx C.M., Blumer J.L. Assessing distress in pediatric intensive care environments: the COMFORT scale. J Pediatr Psychol 1992; 17: 95—109. DOI: 10.1093/jpepsy/17.1.95
7. Carbajal R, Eriksson M., Courtois E., Boyle E., Avila-Al-varez A., Andersen R.D. et al. EUROPAIN Survey Working Group Sedation and analgesia practices in neonatal intensive care units (EUROPAIN): results from a prospective cohort study. Lancet Respir Med 2015; 3: 796-812. DOI: 10.1016/S2213-2600(15)00331-8
8. Steven M.D., Sunil K.S. Manual of Neonatal Respiratory Care. Springer International Publishing Switzerland, 2017; 820. DOI: 10.1007/978-3-319-39839-6
9. Marko T., Dickerson M.L. Clinical handbook of neonatal pain management for nurses. New York, 2017; 219.
10. Williams M.D., Lascelles B.D. Early Neonatal Pain-A Review of Clinical and Experimental Implications on Painful Conditions Later in Life. Front Pediatr 2020; 8: 30. DOI:10.3389/fped.2020.00030
11. Wong D.L, Hess C.S. Clinical Manual of Pediatric Nursing: manual. D.L. Wong. Whaley. St. Louis; Mosby Year Book, 2000; 698.
12. Roofthooft D.W., Simons S.H., Anand K.J., Tibboel D., van Dijk M. Eight years later, are we still hurting newborn infants? Neonatology 2014; 105: 218-226. DOI: 10.1159/000357207
13. Carbajal R., Rousset A., Danan C., Coquery S., Nolent P., Du-crocq S. et al. Epidemiology and treatment of painful procedures in neonates in intensive care units. JAMA 2008; 300: 60-70. DOI: 10.1001/jama.300.1.60
14. Xu W., Walsh S., Cong X.S. Development of Accumulated Pain/Stressor Scale (APSS) in NICUs: A National Survey. Pain Manag Nurs 2016; 17(6): 354-362. DOI: 10.1016/j.pmn.2016.08.004
15. Lyngstad L.T., Tandberg B.S., Storm H., Ekeberg B.L., Moen A. Does skin-to-skin contact reduce stress during diaper change in preterm infants? Early Hum Dev 2014; 90(4): 169— 172. DOI: 10.1016/j.earlhumdev.2014.01.011
16. Taylor B.J., Robbins J.M., Gold J.I., Anand K.J. Assessing postoperative pain in neonates: a multicenter observational study. Pediatrics 2006; 118(4): e992-1000. DOI: 10.1542/peds.2005-3203
17. Perry M., Tan Z, Chen J., Weidig T, Xu W., Cong X.S. Neonatal Pain: Perceptions and Current Practice. Crit Care Nurs Clin North Am 2018; 30(4): 549-561. DOI: 10.1016/j.cnc.2018.07.013
18. Witt N., Coynor S., Edwards C., Bradshaw H. A Guide to Pain Assessment and Management in the Neonate. Curr Emerg Hosp Med Rep 2016; 4: 1-10. DOI:10.1007/s40138-016-0089-y
19. Walden M., Gibbins S. Pain assessment and management guideline for practice (3nd ed.). Glenview, IL: National Association of Neonatal Nurses, 2012; 332.
20. Hummel P., Puchalski M., Creech S.D., Weiss M.G. Clinical reliability and validity of the N-PASS: Neonatal Pain, Agitation, and Sedation Scale with prolonged pain. J Perinatol 2008; 28(1): 55-60. DOI: 10.1038/sj.jp.7211861
21. Krechel S.W., Bindler J. CRIES: A new neonatal postoperative pain measurement score. Initial testing of validity and reliability. Paediatric Anaesthesia 1995; 5: 53-61.
22. AlcockL.J. The development of a tool to assess neonatal pain. Neonatal Network 1993; 12(6): 59-66.
23. Gallo A.M. The fifth vital sign: Implementation of neonatal infant pain scale. Journal of Obstetric, Gynecologic, and Neonatal Nursing 2003; 32(2): 206. DOI: 10.1177/0884217503251745
24. Maaskant P., RaymakersJanssen E., Veldhoen E. Ista E., Lucas C., Vermeulen H. The clinimetric properties of the COMFORT scale: A systematic review. Eur J Pain 2016; 20(10): 1587-1611. DOI: 10.1002/ejp.880
25. Van DijkM., de Boer J.B., Koot H.M., Tibboel D., Passchier J., Duivenvoorden H.J. The reliability and validity of the COMFORT scale as a postoperative pain instrument in 0 to 3-year-old infants. Pain 2000; 84 (23): 367-377.
26. Flick R.P., Hebl J.R. Pain management in the postpartum period. Issues of Clinics in Perinatol 2013; 40 (3): 337-600.
27. Lawrence J., Alcock D., McGrath P., Kay J., MacMurray S.B., Dulberg C. The development of a tool to assess neonatal pain. Neonatal Netw 1993; 12(6): 59-66.
28. Hummel P., Lawlor-Klean P., Weiss M.G. Validity and reliability of the N-PASS assessment tool with acute pain. J Perinatol 2010; 30(7): 474-478. DOI: 10.1038/jp.2009.185
29. Jonsdottir R.B., Kristjansdottir G. The sensitivity of the Premature Infant Pain Profile - PIPP to measure pain in hospitalized neonates. J Eval Clin Pract 2005; 11(6): 598-605.
30. Purser L., Warfield K., Richardson C. Making pain visible: an audit and review of documentation to improve the use of pain assessment by implementing pain as the fifth vital sign. Pain Manag Nurs 2014; 15: 137-142. DOI: 10.1016/j.pmn.2012.07.007
31. Neonatal neurology (collective monograph). V.M. Studenikin, S.S. Shamansurova (eds). Moscow: Medforum, 2014; 480. (in Russ).
Review
For citations:
Andreev A.V., Kharlamova N.V., Mezhinskiy S.S., Shylova N.A., Karpova A.L., Mostovoy А.V., Pesenkina A.A. Clinical assessment of pain in newborns. Rossiyskiy Vestnik Perinatologii i Pediatrii (Russian Bulletin of Perinatology and Pediatrics). 2020;65(4):5-15. (In Russ.) https://doi.org/10.21508/1027-4065-2020-65-4-5-15
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