Pain-Related Reactions among Premature Infants with Gestational Age Less than 26 Weeks: An Observational Cohort Study.
There is insufficient information regarding acute pain reactions among premature infants with a gestational age of less than 26 weeks and no appropriate scale for pain measurement in this age group. We hypothesized that these infants present specific reactions to a standardized pain stimulus within the first 3 days of life.



Mixed-methods, prospective, open-label, single-arm, observational study. Routine capillary or peripheral blood takes were filmed. The model consisting of a baseline, a preparatory, an interventional and a return-to-baseline phase was filmed. After a pilot evaluation, experienced medical and nursing neonatal intensive care unit (NICU) staff analysed the videos.



Twenty infants with gestational ages ranging from 22 weeks and 3 days to 26 weeks (mean 24 weeks) were recruited. Nineteen infants showed pain reactions, with a mean latency of 8.3 s (range 2-30). The majority presented eye movements, changes of the breath pattern and a slight increase in the mean SpO2 value. A high degree of interrater and intrarater reliability was found.



Premature infants with a gestational age of up to 26 weeks can present a variety of discrete reactions as response to a pain stimulus within the first 72 h of life. Experienced NICU staff can perform a valid and reliable evaluation of these reactions.
Children's and Adolescents' Hospital, University Hospital of Cologne, Cologne, Germany.
Kyriakos
K
Martakis
Christoph
C
Hünseler
Kruthika
K
Thangavelu
Angela
A
Kribs
Bernhard
B
Roth
D005260:Female; D005865:Gestational Age; D006339:Heart Rate; D006801:Humans; D062071:Infant, Extremely Premature; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D007363:Intensive Care Units, Neonatal; D008297:Male; D010146:Pain / Q000175:diagnosis*; D010147:Pain Measurement / Q000379:methods*; D011446:Prospective Studies; D015203:Reproducibility of Results; D014741:Video Recording