title: Pain in the preterm neonate: behavioural and physiological indices.
abstract: The impact of invasive procedures on preterm neonates has received little systematic attention. We examined facial activity, body movements, and physiological measures in 56 preterm and full-term newborns in response to heel lancing, along with comparison preparatory and recovery intervals. The measures were recorded in special care and full-term nurseries during routine blood sampling. Data analyses indicated that in all measurement categories reactions of greatest magnitude were to the lancing procedure. Neonates with gestational ages as short as 25-27 weeks displayed physiological responsivity to the heel lance, but only in the heart rate measure did this vary with gestational age. Bodily activity was diminished in preterm neonates in general, relative to full-term newborns. Facial activity increased with the gestational age of the infant. Specificity of the response to the heel lance was greatest on the facial activity measure. Identification of pain requires attention to gestational age in the preterm neonate.
authors.affiliation: University of British Columbia Vancouver, B.C. V6T1Z4 Canada British Columbia Children's Hospital, Vancouver, B.C. V6T1Z4 Canada.
authors.forename: Kenneth D
authors.initials: KD
authors.lastname: Craig
authors.forename: Michael F
authors.initials: MF
authors.lastname: Whitfield
authors.forename: Ruth V E
authors.initials: RVE
authors.lastname: Grunau
authors.forename: Julie
authors.initials: J
authors.lastname: Linton
authors.forename: Heather D
authors.initials: HD
authors.lastname: Hadjistavropoulos
mesh_terms: D001785:Blood Gas Monitoring, Transcutaneous; D002245:Carbon Dioxide / Q000097:blood; D002652:Child Behavior; D002675:Child, Preschool; D005149:Facial Expression; D005260:Female; D006339:Heart Rate; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D010100:Oxygen / Q000097:blood; D010146:Pain / Q000503:physiopathology* / Q000523:psychology*; D012119:Respiration
chemical_list: D002245:Carbon Dioxide; D010100:Oxygen