Chronic Pain in the Neonate

Background

Chronic or prolonged pain has received little attention in neonatal pain research1. Only during the last years data begins to emerge. All but two existing pain assessment instruments have been developed for acute or procedural pain. Two studies describe the validation of a pain assessment tool for prolonged pain (EDIN and the COMFORTneo)2,3. Prolonged pain and stress postoperatively and due to mechanical ventilation has been looked at using the N-PASS tool4. Some factors that may be useful in measuring persistent pain or distress have been identified2,3,4,5. Despite this research a sound definition is lacking. The etiology is unknown, and there is no understanding of pathofysiology and prevalence of chronic pain in the newborn. A description of the concept of pain beyond acute in the newborn is necessary6.

Literature

  1. Anand KJS, Stevens BJ, McGrath PJ (eds). Pain in Neonates and Infants, 3d edition. Elsevier 2007.
  2. Debillon T et al. Development and initial validation of the EDIN scale, a new tool for assessing prolonged pain in preterm infants. Arch Dis Child Fetal Neonatal Ed 2001; 85: F36-41.
  3. Van Dijk M et al. Taking up the challenge of measuring prolonged pain in (premature) neonates; the COMFORTneo Scale seems promising. Clin J Pain 2009; 27: 607-616.
  4. Hummel P et al. Clinical reliability and validity of the N-PASS: neonatal pain, agitation and sedation scale with prolonged pain. J of Perinatology2008; 28: 55-60.
  5. Boyle EM et al. Assessment of persistent pain or distress and adequacy of analgesia in preterm ventilated infants. Pain 2006; 124: 87-91.
  6. Stevens BJ. Looking beyond acute pain in infancy. Pain 2006; 124: 11-12.

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