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Assessment of neonatal pain

Kanwaljeet JS Anand, MBBS, DPhil, FAAP, FCCM, FRCPCH
Section Editor
Richard Martin, MD
Deputy Editor
Melanie S Kim, MD


Neonatal discomfort, stress, or pain may be associated with routine patient care (eg, physical examination and diaper changes), moderately invasive care measures (eg, suctioning, phlebotomy, and peripheral intravenous line placement), or more invasive procedures (eg, chest tube placement and circumcision).

Pain in the neonate can be classified into three categories [1]:

Acute or physiological pain occurs from skin-breaking procedures or tissue injury caused by diagnostic or therapeutic interventions. Infants admitted to the neonatal intensive care unit (NICU) repeatedly experience acute pain from an average of 12 to 16 invasive procedures each day [2,3].

Established pain occurs following surgery, localized inflammatory conditions (eg, abscess or thrombophlebitis), or birth-related trauma.

Prolonged or chronic pain results from severe diseases such as necrotizing enterocolitis or meningitis, or rare conditions such as scalded skin syndrome or Harlequin syndrome. (See "Vesiculobullous and pustular lesions in the newborn", section on 'Staphylococcal scalded skin syndrome'.)


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Literature review current through: Apr 2016. | This topic last updated: Nov 6, 2013.
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