title: Multidimensional pain assessment of preterm newborns at the 1st, 3rd and 7th days of life.
abstract: OBJECTIVE
  It is challenge to assess and treat pain in premature infants. The objective of this study was to compare the multidimensional pain assessment of preterm neonates subjected to an acute pain stimulus at 24 hours, 72 hours and seven days of life.
  
  
  METHODS
  Prospective cohort study, at Universidade Federal de São Paulo.
  
  
  METHODS
  Eleven neonates with gestational age less than 37 weeks that needed venepuncture for blood collection were studied. The exclusion criteria were Apgar score < 7 at five minutes, presence of any central nervous system abnormality, and discharge or death before seven days of life. Venepuncture was performed in the dorsum of the hand, and the heart rate, oxygen saturation and pain scales [Neonatal Facial Coding System (NFCS), Neonatal Infant Pain Scale (NIPS), and Premature Infant Pain Profile (PIPP)] were assessed at 24 hours, 72 hours and 7 days of life. NFCS and NIPS were evaluated prior to procedure (Tpre), during venepuncture (T0), and two (T2) and five (T5) minutes after needle withdrawal. Heart rate, O2 saturation and PIPP were measured at Tpre and T0. Mean values were compared by repeated-measurement analysis of variance.
  
  
  RESULTS
  The pain parameters did not differ at 24 hours, 72 hours and 7 days of life: heart rate (p = 0.22), oxygen saturation (p = 0.69), NFCS (p = 0.40), NIPS (p = 0.32) and PIPP (p = 0.56).
  
  
  CONCLUSIONS
  Homogeneous pain scores were observed following venepuncture in premature infants during their first week of life.
authors.affiliation: Division of Neonatal Medicine, Department of Pediatrics, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, CEP 01410-020, Brazil.
authors.forename: Ana Beatriz Mello
authors.initials: AB
authors.lastname: Serpa
authors.forename: Ruth
authors.initials: R
authors.lastname: Guinsburg
authors.forename: Rita de Cássia Xavier
authors.initials: Rde C
authors.lastname: Balda
authors.forename: Amélia Miyashiro Nunes
authors.initials: AM
authors.lastname: dos Santos
authors.forename: Kelsy Catherina Nena
authors.initials: KC
authors.lastname: Areco
authors.forename: Clóvis Araújo
authors.initials: CA
authors.lastname: Peres
mesh_terms: D000704:Analysis of Variance; D001800:Blood Specimen Collection / Q000523:psychology; D015331:Cohort Studies; D005149:Facial Expression; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D018730:Infant Behavior / Q000523:psychology; D007231:Infant, Newborn; D007234:Infant, Premature / Q000523:psychology*; D010100:Oxygen / Q000502:physiology; D010146:Pain / Q000523:psychology*; D010147:Pain Measurement / Q000379:methods*; D018743:Perinatal Care; D011446:Prospective Studies; D011677:Punctures / Q000523:psychology; D013997:Time Factors
chemical_list: D010100:Oxygen