title: Assessment and management of acute pain in high-risk neonates.
abstract: Neonates in the neonatal intensive care unit experience hundreds of painful procedures at a time of rapid neurological development. Although the immediate responses to pain may be protective, the potential long-term effects of early and under-treated pain are concerning. As pain assessment is the first step in the provision of appropriate and timely pain management, attention should be directed to the quantification of pain in terms of its location, severity, intensity and duration. Over the past decade, numerous pain measures have been developed for preterm and term neonates, however, most of them have been developed for research purposes and have not been tested in the clinical setting. In order to effectively implement pain measures in the clinical setting, the psychometric properties of reliability, validity, feasibility and clinical utility must be established. This review paper will highlight the importance of neonatal pain assessment and examine the psychometric properties of various measures of neonatal pain. Pharmacological and non-pharmacological interventions to manage acute pain in high-risk neonates will be addressed and future research topics will be proposed.
authors.affiliation: Sunnybrook Women's College Health Sciences Centre, 76 Grenville Ave, Room 445, Toronto, Ontario, Canada, M5A 1B2. sharyn.gibbins@swchsc.on.ca
authors.forename: Sharyn
authors.initials: S
authors.lastname: Gibbins
authors.forename: Bonnie
authors.initials: B
authors.lastname: Stevens
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Asztalos
mesh_terms: D000700:Analgesics; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D010146:Pain / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology; D010147:Pain Measurement; D011594:Psychometrics; D015203:Reproducibility of Results; D012307:Risk Factors; D013395:Sucrose / Q000627:therapeutic use
chemical_list: D000700:Analgesics; D013395:Sucrose