PEDIATRICS Vol. 98 No. 5 November 1996, pp. 925-930
This Article
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrowRequest Permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Johnston, C. C.
Right arrow Articles by Stevens, B. J.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Johnston, C. C.
Right arrow Articles by Stevens, B. J.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Facebook   Add to Reddit   Add to Technorati   Add to Twitter  
What's this?

Experience in a Neonatal Intensive Care Unit Affects Pain Response

C. Céleste Johnston RN, DEd1 and Bonnie J. Stevens RN, PhD2

1 Neonatal intensive care units of the Royal Victoria Hospital, Montreal and Mt Sinai Hospital, Toronto, Canada; School of Nursing, McGill University, Montreal, Canada
2 Neonatal intensive care units of the Royal Victoria Hospital, Montreal and Mt Sinai Hospital, Toronto, Canada; Faculty of Nursing, University of Toronto, Toronto, Canada

Objective. To determine the effect of being in the neonatal intensive care unit (NICU) on pain responses in infants of 32 weeks' postconceptual age (PCA).

Design. A cross-sectional comparative design was used.

Setting. Two level III NICUs, each in metropolitan, university teaching hospitals.

Patients. Infants of 32 weeks' PCA born within the past 4 days (the newly born group; n = 53) were compared with infants of the same PCA who had been born 4 weeks earlier (the earlier-born group; n = 36) and had spent that time in an NICU.

Outcome Measures. Heart rate, oxygen saturation levels, and facial actions were used as outcomes in a between-group repeated measures analysis of variance across the heel stick procedure. Background variables of Apgar, weight at birth and data collection, severity of illness, age group, and total number of invasive procedures were entered into a stepwise regression.

Results. The two groups responded differently to the heel stick: the earlier-born infants had less behavioral manifestations of pain than the newly born infants. The number of invasive procedures was the primary factor that explained those behavioral differences, with Apgar as a second explanatory factor. The earlier-born infants had higher heart rates and lower oxygen saturation than the newly born infants before as well as during the procedure. These physiological differences were explained by the perinatal factors of age at birth and birth weight.

Conclusion. Preterm infants who spend PCA weeks 28 through 32 in an NICU are less mature in their pain response than newborn premature infants of 32 weeks' PCA. Greater frequency of invasive procedures is associated with behavioral immaturity, whereas birth factors are associated with physiological immaturity.

Submitted on August 23, 1995
Accepted on January 18, 1996


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Facebook Facebook   Add to Reddit Reddit   Add to Technorati Technorati   Add to Twitter Twitter    What's this?


This article has been cited by other articles:


Home page
 Arch. Dis. Child. Fetal Neonatal Ed.Home page
S S Dalal, D Chawla, J Singh, R K Agarwal, A K Deorari, and V K Paul
Limb splinting for intravenous cannulae in neonates: a randomised controlled trial
Arch. Dis. Child. Fetal Neonatal Ed., November 1, 2009; 94(6): F394 - F396.
[Abstract] [Full Text] [PDF]

Home page
 Arch. Dis. Child. Fetal Neonatal Ed.Home page
G Ancora, M Mastrocola, C Bagnara, D Zola, L Pierantoni, G Rossi, L Corvaglia, and G Faldella
Influence of gestational age on the EDIN score: an observational study
Arch. Dis. Child. Fetal Neonatal Ed., January 1, 2009; 94(1): F35 - F38.
[Abstract] [Full Text] [PDF]

Home page
 JAMAHome page
R. Carbajal, A. Rousset, C. Danan, S. Coquery, P. Nolent, S. Ducrocq, C. Saizou, A. Lapillonne, M. Granier, P. Durand, et al.
Epidemiology and Treatment of Painful Procedures in Neonates in Intensive Care Units
JAMA, July 2, 2008; 300(1): 60 - 70.
[Abstract] [Full Text] [PDF]

Home page
 J Pediatr PsycholHome page
R. R. Pillai Riddell and K. D. Craig
Judgments of Infant Pain: The Impact of Caregiver Identity and Infant Age
J. Pediatr. Psychol., June 1, 2007; 32(5): 501 - 511.
[Abstract] [Full Text] [PDF]

Home page
 PediatricsHome page
K. J. S. Anand
Pain Assessment in Preterm Neonates
Pediatrics, March 1, 2007; 119(3): 605 - 607.
[Full Text] [PDF]

Home page
 Arch. Dis. Child. Fetal Neonatal Ed.Home page
K J S Anand and R W Hall
Pharmacological therapy for analgesia and sedation in the newborn.
Arch. Dis. Child. Fetal Neonatal Ed., November 1, 2006; 91(6): F448 - F453.
[Abstract] [Full Text] [PDF]

Home page
 JAMAHome page
S. J. Lee, H. J. P. Ralston, E. A. Drey, J. C. Partridge, and M. A. Rosen
Fetal Pain: A Systematic Multidisciplinary Review of the Evidence
JAMA, August 24, 2005; 294(8): 947 - 954.
[Abstract] [Full Text] [PDF]

Home page
 PediatricsHome page
R. Carbajal, R. Lenclen, M. Jugie, A. Paupe, B. A. Barton, and K. J. S. Anand
Morphine Does Not Provide Adequate Analgesia for Acute Procedural Pain Among Preterm Neonates
Pediatrics, June 1, 2005; 115(6): 1494 - 1500.
[Abstract] [Full Text] [PDF]

Home page
 PediatricsHome page
W. T. Zempsky, J. P. Cravero, and Committee on Pediatric Emergency Medicine, and Sec
Relief of Pain and Anxiety in Pediatric Patients in Emergency Medical Systems
Pediatrics, November 1, 2004; 114(5): 1348 - 1356.
[Abstract] [Full Text] [PDF]

Home page
 PediatricsHome page
L. Holsti, R. E. Grunau, T. F. Oberlander, and M. F. Whitfield
Specific Newborn Individualized Developmental Care and Assessment Program Movements Are Associated With Acute Pain in Preterm Infants in the Neonatal Intensive Care Unit
Pediatrics, July 1, 2004; 114(1): 65 - 72.
[Abstract] [Full Text] [PDF]

Home page
 Arch. Dis. Child. Fetal Neonatal Ed.Home page
A B Acharya, S Annamali, N A Taub, and D Field
Oral sucrose analgesia for preterm infant venepuncture
Arch. Dis. Child. Fetal Neonatal Ed., January 1, 2004; 89(1): F17 - F18.
[Full Text] [PDF]

Home page
 Arch Pediatr Adolesc MedHome page
C. C. Johnston, B. Stevens, J. Pinelli, S. Gibbins, F. Filion, A. Jack, S. Steele, K. Boyer, and A. Veilleux
Kangaroo Care Is Effective in Diminishing Pain Response in Preterm Neonates
Arch Pediatr Adolesc Med, November 1, 2003; 157(11): 1084 - 1088.
[Abstract] [Full Text] [PDF]

Home page
 Journal of Research in NursingHome page
L. S. Franck
Nursing management of children's pain: Current evidence and future directions for research
Journal of Research in Nursing, September 1, 2003; 8(5): 330 - 353.
[Abstract] [PDF]

Home page
 Journal of Pharmacy PracticeHome page
P. C. Walker and D. S. Wagner
Treatment of Pain in Pediatric Patients
Journal of Pharmacy Practice, August 1, 2003; 16(4): 261 - 275.
[Abstract] [PDF]

Home page
 PediatricsHome page
J. W. B. Peters, H. M. Koot, J. B. de Boer, J. Passchier, J. M. Bueno-de-Mesquita, F. H. de Jong, H. J. Duivenvoorden, and D. Tibboel
Major Surgery Within the First 3 Months of Life and Subsequent Biobehavioral Pain Responses to Immunization at Later Age: A Case Comparison Study
Pediatrics, January 1, 2003; 111(1): 129 - 135.
[Abstract] [Full Text] [PDF]

Home page
 PediatricsHome page
C. C. Johnston, F. Filion, L. Snider, A. Majnemer, C. Limperopoulos, C.-D. Walker, A. Veilleux, E. Pelausa, H. Cake, S. Stone, et al.
Routine Sucrose Analgesia During the First Week of Life in Neonates Younger Than 31 Weeks' Postconceptional Age
Pediatrics, September 1, 2002; 110(3): 523 - 528.
[Abstract] [Full Text] [PDF]

Home page
 PediatricsHome page
T. F. Oberlander, R. E. Grunau, C. Fitzgerald, and M. F. Whitfield
Does Parenchymal Brain Injury Affect Biobehavioral Pain Responses in Very Low Birth Weight Infants at 32 Weeks' Postconceptional Age?
Pediatrics, September 1, 2002; 110(3): 570 - 576.
[Abstract] [Full Text] [PDF]

Home page
 PediatricsHome page
R. Carbajal, R. Lenclen, V. Gajdos, M. Jugie, and A. Paupe
Crossover Trial of Analgesic Efficacy of Glucose and Pacifier in Very Preterm Neonates During Subcutaneous Injections
Pediatrics, August 1, 2002; 110(2): 389 - 393.
[Abstract] [Full Text] [PDF]

Home page
 Arch. Dis. Child. Fetal Neonatal Ed.Home page
T Debillon, V Zupan, N Ravault, J-F Magny, M Dehan, and H H ABU-SAAD
Development and initial validation of the EDIN scale, a new tool for assessing prolonged pain in preterm infants
Arch. Dis. Child. Fetal Neonatal Ed., July 1, 2001; 85(1): F36 - 41.
[Abstract] [Full Text] [PDF]

Home page
 NeuroscientistHome page
M. Fitzgerald and S. Beggs
Book Review: The Neurobiology of Pain: Developmental Aspects
Neuroscientist, June 1, 2001; 7(3): 246 - 257.
[Abstract] [PDF]

Home page
 PediatricsHome page
R. E. Grunau, T. F. Oberlander, M. F. Whitfield, C. Fitzgerald, and S. K. Lee
Demographic and Therapeutic Determinants of Pain Reactivity in Very Low Birth Weight Neonates at 32 Weeks' Postconceptional Age
Pediatrics, January 1, 2001; 107(1): 105 - 112.
[Abstract] [Full Text]

Home page
 Arch. Dis. Child. Fetal Neonatal Ed.Home page
H Vertanen, V Fellman, M Brommels, and L Viinikka
An automatic incision device for obtaining blood samples from the heels of preterm infants causes less damage than a conventional manual lancet
Arch. Dis. Child. Fetal Neonatal Ed., January 1, 2001; 84(1): 53F - 55.
[Abstract] [Full Text]

Home page
 Arch Pediatr Adolesc MedHome page
R. d. C. Xavier Balda, R. Guinsburg, M. F. B. d. Almeida, C. d. A. Peres, M. H. Miyoshi, and B. I. Kopelman
The Recognition of Facial Expression of Pain in Full-Term Newborns by Parents and Health Professionals
Arch Pediatr Adolesc Med, October 1, 2000; 154(10): 1009 - 1016.
[Abstract] [Full Text] [PDF]

Home page
 PediatricsHome page
Committee on Fetus and Newborn, Committee on Drugs and Canadian Paediatric Society, Fetus and Newborn Com
Prevention and Management of Pain and Stress in the Neonate
Pediatrics, February 1, 2000; 105(2): 454 - 461.
[Abstract] [Full Text] [PDF]

Home page
 PediatricsHome page
T. F. Oberlander, R. E. Grunau, M. F. Whitfield, C. Fitzgerald, S. Pitfield, and J. P. Saul
Biobehavioral Pain Responses in Former Extremely Low Birth Weight Infants at Four Months' Corrected Age
Pediatrics, January 1, 2000; 105(1): e6 - e6.
[Abstract] [Full Text] [PDF]

Home page
 PediatricsHome page
G. Suresh;, W. T. Zempsky, N. L. Schechter;, J. L. Fox;, E. M. Connor, D. Carlin, F. H. Top, J. MD, and L. E. Weisman
IMpact-RSV Study Group Report
Pediatrics, October 1, 1999; 104(4): 993 - 994.
[Full Text]

Home page
 PediatricsHome page
F. L. Porter, C. M. Wolf, and J. P. Miller
Procedural Pain in Newborn Infants: The Influence of Intensity and Development
Pediatrics, July 1, 1999; 104(1): 13e - 13.
[Abstract] [Full Text]

Home page
 PediatricsHome page
F. L. Porter, C. M. Wolf, and J. P. Miller
The Effect of Handling and Immobilization on the Response to Acute Pain in Newborn Infants
Pediatrics, December 1, 1998; 102(6): 1383 - 1389.
[Abstract] [Full Text] [PDF]

Home page
 PediatricsHome page
A. Taddio, A. Ohlsson, T. R. Einarson, B. Stevens, and G. Koren
A Systematic Review of Lidocaine-Prilocaine Cream (EMLA) in the Treatment of Acute Pain in Neonates
Pediatrics, February 1, 1998; 101 (2): e1 - e1.
[Abstract] [Full Text] [PDF]