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Pain and preterm infant

Almudena Alonso-Ojembarrena, Antonio Segado-Arenas, Isabel Benavente-Fernández, Simón Pedro Lubián-López
We describe our experience with helmet-delivered continuous positive airway pressure in five preterm newborns. We analyzed oxygen requirement, arterial oxygen saturation, respiratory rate, medium arterial pressure, heart rate, apneic spells and patient's comfort. The patients' vital signs or pain scale were not different before and after treatment.
February 15, 2018: Indian Pediatrics
Vivek V Shukla, Satvik Bansal, Archana Nimbalkar, Apurva Chapla, Ajay Phatak, Dipen Patel, Somashekhar Nimbalkar
OBJECTIVE: To compare individual efficacy and additive effects of pain control interventions in preterm neonates. DESIGN: Randomized controlled trial. SETTING: Level-3 University affiliated neonatal intensive care unit. PARTICIPANTS: 200 neonates (26-36 weeks gestational age) requiring heel-stick for bedside glucose assessment. Exclusion criteria were neurologic impairment and critical illness precluding study interventions...
February 9, 2018: Indian Pediatrics
Pamela Douglas, Donna Geddes
BACKGROUND: breastfeeding optimises health outcomes for both mothers and infants. Although most women want to breastfeed, they report commencing infant formula because of nipple pain, unsettled infant behaviour, and infant growth concerns. To date, existing approaches to fit and hold ('latch and positioning') have been demonstrated not to help breastfeeding outcomes, and women report widespread dissatisfaction with the quality of support and conflicting advice they receive. Breast and nipple pain, difficulty with latching and sucking, fussing at the breast, back-arching, marathon feeds, excessively frequent feeds, poor weight gain, breast refusal, and crying due to poor satiety often signal suboptimal positional instability and impaired milk transfer, but may be misdiagnosed as medical conditions...
March 2018: Midwifery
Livio Provenzi, Roberto Giorda, Monica Fumagalli, Uberto Pozzoli, Francesco Morandi, Giunia Scotto di Minico, Fabio Mosca, Renato Borgatti, Rosario Montirosso
Very preterm (VPT) infants (gestational age < 32 weeks) require long-lasting hospitalization in the Neonatal Intensive Care Unit (NICU), even in absence of severe morbidities. During NICU stay, life-saving interventions occur and include invasive and painful skin-breaking procedures (NICU-related stress), which constitute a major early adverse experience for VPT infants. Telomeres are repeat-sequence at the end of chromosomes, which shorten with age and are highly susceptible to life adversities: the exposure to early adverse experiences is associated with shorter telomere length (TL)...
January 20, 2018: Psychoneuroendocrinology
Linda A Hatfield, Rebecca K Hoffman, Rosemary C Polomano, Yvette Conley
PURPOSE: To recruit healthy full- and preterm infants into genetic research and determine the effectiveness of a noninvasive DNA sampling technique for comparing epigenetic modifications. BACKGROUND: Noxious stimuli during a vulnerable period of infant neuronal plasticity may trigger long-term epigenetic changes affecting neurodevelopment, pain modulation, and reactivity. Recognizing epigenetic pain findings is problematic because parents are reluctant to enroll newborns into genetic research...
January 1, 2018: Biological Research for Nursing
C Cremillieux, A Makhlouf, V Pichot, B Trombert, H Patural
BACKGROUND: Objective tools are needed to improve pain assessment in newborns. The aim of this study was to assess the correlation between the Newborn Infant Parasympathetic Evaluation (NIPE) index and two pain scales during a painful procedure in premature infants. METHOD: Each baby born at least at 26 weeks of gestational age (GA) undergoing a planned painful procedure in the Neonatal Intensive Care Unit (NICU) was eligible. NIPE index, heart rate variability (HRV) indices and Neonatal Acute Pain scale (DAN) were recorded across three periods: the first at rest 5 min before the painful procedure (T1), the second during it (T2), and the third 3 min after the end of it (T3)...
January 25, 2018: European Journal of Pain: EJP
Dilek Küçük Alemdar, Fatma Güdücü Tüfekcİ
AIM: This study aimed to evaluate the effects of providing prerecorded maternal heart sounds on the level of pain and comfort that are experienced by preterm infants during aspiration. METHODS: This was a randomized controlled trial. Preterm infants (N = 62) who were receiving care or treatment at a neonatal intensive care unit were eligible for participation in this study. Infants in the intervention group (n = 32) were provided with prerecorded maternal heart sounds before, during, and after aspiration, whereas the infants in the control group (n = 30) received routine care...
January 17, 2018: Japan Journal of Nursing Science: JJNS
Maria A Hernandez, Lucio Palazzi, Julio Lapalma, Joseph Cravero
Neuro-axial anesthesia has been the preferred technique for inguinal hernia repair when attempting to avoid general anesthesia in neonates and preterm infants. We present a case where an erector spinae plane block was used successfully for this surgery. Hemodynamic stability, minimal anesthetic requirements, and excellent pain control were documented. This block promises to be a valuable and safe alternative for inguinal hernia repair, accompanying the path of neuroprotective anesthesia.
January 17, 2018: Paediatric Anaesthesia
Caterina Coviello, Marina Popple Martinez, Livia Drovandi, Corsini Iuri, Valentina Leonardi, Clara Lunardi, Carla Antonelli, Simone Pratesi, Carlo Dani
AIM: This Italian study evaluated whether painful procedures during the first four weeks of life were related to subsequent weight gain, head circumference (HC) and neurodevelopmental outcomes in preterm infants, METHODS: We evaluated the number of invasive procedures that infants born at less than 32 weeks of gestational age (GA) underwent in the Neonatal Intensive Care Unit of Careggi Hospital, Florence from January to December 2015. Weight and HC were recorded at birth, 36 weeks of PMA and six and 12 months of CA...
January 17, 2018: Acta Paediatrica
(no author information available yet)
OBJECTIVE: Mechanical ventilation (MV) in preterm infants (PTI) causes discomfort. Whether it causes pain is controversial. Meta analysis reviews of published work on PTI during MV have shown no clinically significant impact of opioids on pain scales, and hence not recommended for routine use in neonatal intensive care units (NICUs). Similarly regular use of sedative midazolam is also not recommended. Therefore we hypothesized a downward trend in narcotics and sedatives used in MV of PTI in NICUs...
January 2018: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
Palee Myrex, Lorie Harper, Sara Gould
A female with gestational diabetes presented with hip pain characteristic of meralgia paresthetica and trochanteric bursitis. She had similar episodes prior to pregnancy that were treated successfully with non-steroidal anti-inflammatory drugs (NSAIDs) and corticosteroid injections. However, NSAID use during pregnancy poses risks to the fetus and corticosteroids carry a risk of hyperglycemia, especially in those with diabetes. Unfortunately, all attempts made to treat her conservatively failed to improve her symptoms...
January 5, 2018: Sports Medicine—Open
Beatriz Oliveira Valeri, Cláudia Maria Gaspardo, Francisco Eulógio Martinez, Maria Beatriz Martins Linhares
BACKGROUND: Preterm infants (PI) requiring the Neonatal Intensive Care Unit (NICU) are exposed to early repetitive pain/distress. Little is known about how pain relief strategies interact with infants'clinical health status, such as severity of illness with pain responses. This study aimed to examine main and interactive effects of routine sucrose intervention and neonatal clinical risk (NCR) on biobehavioral pain reactivity-recovery in PI during painful blood collection procedures. METHODS: Very-low birthweight PI (n=104) were assigned to Low and High Clinical Risk Groups, according to the Clinical Risk Index for Babies...
January 3, 2018: Clinical Journal of Pain
Juliane Schneider, Emma G Duerden, Ting Guo, Karin Ng, Patric Hagmann, Myriam Bickle Graz, Ruth E Grunau, M Mallar Chakravarty, Petra S Hüppi, Anita C Truttmann, Steven P Miller
Our objectives were to determine whether procedural pain and glucose exposure are associated with altered structural and functional brain development differently in preterm males and females, and neurodevelopment at 18-month corrected age. Fifty-one very preterm neonates (22 males; median [interquartile range] gestational age 27.6 [2.0] weeks) underwent 3 serial scans including T1-weighted and resting-state functional magnetic resonance imaging (MRI) at median postmenstrual weeks: 29.4, 31.9, and 41.1. Thalamus, basal ganglia, and total brain volumes were segmented...
March 2018: Pain
Aletta Rheeder, Welma Lubbe, Christa S J van der Walt, Ronel Pretorius
Neurodevelopmental supportive care provides preterm infants with evidence-based care to ensure the best possible neurological outcomes. The study aimed to determine the compliance of current nursing care practices with best practice guidelines by means of a situational analysis. The situational analysis was done in 2 cycles in the neonatal intensive care units (n = 25) of a private healthcare provider in South Africa. Structured observations were done in cycle 1 using the Implementation of Neurodevelopmental Supportive Care checklist...
November 30, 2017: Journal of Perinatal & Neonatal Nursing
Claudia M Gaspardo, Rafaela G M Cassiano, Sofia M A Gracioli, Guilherme C B Furini, Maria Beatriz M Linhares
Objective: To examine the effects of individual characteristics of neonates and neonatal pain-related stress on attention problems and externalizing behavior problems of toddlers born preterm, analyzing the moderating effects of the dispositional traits of temperament. Methods: The sample included 62 toddlers aged 18-36 months and their mothers. The mothers were interviewed using the Child Behavior Checklist 1.5-5 for toddlers' attention and externalizing behavior problems assessment, the Early Childhood Behavior Questionnaire for toddlers' temperament assessment, and the Adult Temperament Questionnaire for their temperament assessment...
November 17, 2017: Journal of Pediatric Psychology
Livio Provenzi, Giunia Scotto di Minico, Roberto Giorda, Rosario Montirosso
Preterm infants present an immature neurobehavioral profile at birth, even in absence of severe brain injuries and perinatal complications. As such, they require a long-lasting hospitalization in the Neonatal Intensive Care Unit (NICU), which is thought to grant at-risk newborns' survival, but still entails a number of physical, painful, and socio-emotional stressors. Hence, preterm birth and NICU stay represent an early adverse experience, which has been linked to detrimental consequences for neurological, neuro-endocrinal, behavioral, and socio-emotional development, as well as to disease later in life...
2017: Frontiers in Endocrinology
L Collados-Gómez, P Ferrera-Camacho, E Fernandez-Serrano, V Camacho-Vicente, C Flores-Herrero, A M García-Pozo, R Jiménez-García
AIM: Repeated, ongoing exposure to pain influences the growth, cognitive and motor functions, behaviour, personality and neurodevelopment of preterm infants. We compared the analgesic effects of expressed breast milk (EBM) and 24% oral sucrose on preterm neonates during venipuncture. METHODS: This multicentre randomised, noninferiority, crossover trial focused on five neonatal university units in Madrid, Spain, from October 2013 to October 2014. It comprised 66 preterm infants born at less than 37 weeks and randomly split into two groups...
November 18, 2017: Acta Paediatrica
Saumil Desai, Ruchi Nimish Nanavati, Rohit Nathani, Nandkishor Kabra
Objective: The objective of our study was to assess the pain associated with suctioning in preterm neonates on assisted ventilation and comparing the use of expressed breast milk (EBM), sucrose, and swaddling to alleviate pain. Methods: Study design: A randomized controlled clinical trial. Inclusion Criteria: Preterm neonates on assisted ventilation. Exclusion Criteria: Major congenital anomalies and severe encephalopathy...
October 2017: Indian Journal of Palliative Care
S Juujärvi, T Saarela, M Hallman, O Aikio
AIM: Symptomatic patent ductus arteriosus may lead to serious complications in extremely preterm and extremely low birth weight infants and is often resistant to medication. We evaluated early intravenous paracetamol for pain prevention during respiratory therapy, in an attempt to understand the ductal treatment of such infants. METHODS: Our cohort were 295 extremely preterm or extremely low birth weight infants, born at less than 28 weeks or 1,000g, respectively, who were treated in the neonatal intensive care unit of Oulu University Hospital from 2002-2015, before and after intravenous paracetamol was introduced in June 2009...
November 4, 2017: Acta Paediatrica
Hsueh-Fang Peng, Ti Yin, Luke Yang, Chi Wang, Yue-Cune Chang, Mei-Jy Jeng, Jen-Jiuan Liaw
BACKGROUND: Preterm infant pain can be relieved by combining non-nutritive sucking (sucking), oral sucrose, and facilitated tucking (tucking), but the pain-relief effects of oral expressed breast milk (breast milk) are ambiguous. AIMS: We compared the effects of combined sucking+ breast milk, sucking+breast milk+tucking, and routine care on preterm infant pain during and after heel-stick procedures. DESIGN: A prospective, randomized controlled trial...
October 8, 2017: International Journal of Nursing Studies
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