title: EDIN Scale Implemented by Gestational Age for Pain Assessment in Preterms: A Prospective Study.
abstract: Background.Chronic neonatal pain can lead to long-term adverse effects on the immature brain. EDIN scale for prolonged pain might not be fully suitable for premature infants. We aimed to test a modified EDIN scale, adding postmenstrual age (PMA) as a sixth item (EDIN6).Methods.In a two-phase prospective study, pain was assessed in all neonates admitted in our NICU. InT1 EDIN was applied; inT2 EDIN6 with additional scores of 2, 1, and 0, respectively, for 25-32, 33-37, and >37 weeks PCA was tested. Scores > 6 suggested pain. The nursing staff was given a questionnaire to evaluate EDIN and EDIN6.Results.A total of 15960 pain assessments were recorded (8693 inT1; 7267 inT2). With EDIN6, cumulative detection of pain almost tripled (117/7267 versus 52/8693,p= 0.001). Main differences were found among less mature categories (50/1472 versus 17/1734,p= 0.001 in PCA 25-32; 26/2606 versus 10/4335,p= 0.001 in PMA 33-37; 41/3189 versus 25/2624,p= 0.26 in PMA > 37). Adequacy of pain assessment in lower PMA was judged "medium-high" in 13,4% of nurses inT1 and 71,4% inT2.Conclusions.EDIN6 may allow improved evaluation of pain in preterm infants.
authors.affiliation: NICU, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy.
authors.forename: G
authors.identifier: 0000-0001-9175-9394
authors.initials: G
authors.lastname: Raffaeli
authors.affiliation: NICU, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy.
authors.forename: G
authors.identifier: 0000-0003-1092-5130
authors.initials: G
authors.lastname: Cristofori
authors.affiliation: NICU, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy.
authors.forename: B
authors.identifier: 0000-0002-5896-2654
authors.initials: B
authors.lastname: Befani
authors.affiliation: NICU, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy.
authors.forename: A
authors.identifier: 0000-0001-7880-4947
authors.initials: A
authors.lastname: De Carli
authors.affiliation: NICU, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy.
authors.forename: G
authors.identifier: 0000-0002-4921-1437
authors.initials: G
authors.lastname: Cavallaro
authors.affiliation: NICU, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy.
authors.forename: M
authors.identifier: 0000-0002-0186-0710
authors.initials: M
authors.lastname: Fumagalli
authors.affiliation: NICU, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy.
authors.forename: L
authors.identifier: 0000-0002-7110-3141
authors.initials: L
authors.lastname: Plevani
authors.affiliation: NICU, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Mosca
mesh_terms: D003710:Demography; D005865:Gestational Age; D019538:Health Care Surveys; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000502:physiology*; D009740:Nursing Staff / Q000706:statistics & numerical data; D010147:Pain Measurement / Q000379:methods*; D011446:Prospective Studies