Title

The physiology, assessment, and treatment of neonatal pain.

Document Type

Article

Publication Date

8-2023

Identifier

DOI: 10.1016/j.siny.2023.101465

Abstract

Studies have clearly shown that development of pain receptors starts as early as 20-weeks' gestation. Despite contrary belief, the human fetus develops a similar number of receptive pain fibers as seen in adults. These receptors' maturation is based on response to sensory stimuli received after birth which makes the NICU a critical place for developing central nervous system's pain perception. In practice, the assessment of pain relies mostly on bedside staff. In this review we will discuss the various developing features of pain pathways in the neonatal brain and the modification of pain perception secondary to various interactions immediately after birth. We also discuss the various tools utilized in the NICU for pain assessment that rely on physiological and behavioral patterns. Finally, we address the management of pain in the NICU by either pharmacological or non-pharmacological intervention while highlighting potential benefits, disadvantages, and situations where one may be preferred over another.

Journal Title

Seminars in fetal & neonatal medicine

Volume

28

Issue

4

First Page

101465

Last Page

101465

MeSH Keywords

Infant, Newborn; Adult; Humans; Intensive Care Units, Neonatal; Gestational Age; Pain; Pain Measurement

Keywords

NICU; Neonatal; Pain; Scores

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