The Effects of Different Procedures on Pain Levels at Preterm and Term Infants in Neonatal Intensive Care Unit
Condition: Pain; Newborn; Preterm; Term; Venipuncture
MeSH terms: Premature Birth
Study type: Observational [Patient Registry]

Summary: 
      Accurate assessment of pain in neonates in the neonatal intensive care unit (NICU) is vital
      because of the high prevalence of painful experiences, including both daily procedural pain
      and postoperative pain, in this population. It has been reported that newborns born between
      the gestational ages (GY) 25-42 and hospitalized in the NICU undergo an average of 14 painful
      procedures per day in the first 2 weeks of life. The aim of this study is determinin the
      effect of different procedures on the pain levels of newborns in the Neonatal Intensive Care
      Unit (NICU).
    

Detailed description: 
      Accurate assessment of pain in neonates in the neonatal intensive care unit (NICU) is vital
      because of the high prevalence of painful experiences, including both daily procedural pain
      and postoperative pain, in this population. Exposure of these infants to many mandatory
      invasive procedures and poor pain management during this time may lead to different results
      in the short and long term. Every painful application in newborns causes behavioral and
      physiological instability. Repeated exposure to painful stimuli produces long-term changes in
      stress-sensitive brain systems such as the hypothalamic-adrenal system and the developing
      brain. Therefore, evaluation and prevention of pain in newborns is essential. In the NICU,
      many medical interventions are often performed on infants that are repetitive, painful, but
      diagnostically necessary. All environmental stress factors can cause physiological changes
      such as increased pulse, blood pressure, respiratory rate and a decrease in oxygen saturation
      in newborns. Increasing energy expenditure to overcome these changes may affect physiological
      functioning, slowing recovery and adversely affecting the organization of the central nervous
      system (CNS). Heel blood (TC), vascular access (DY), naso and orogastric (NG-OG) catheter
      insertion, arterial blood collection, tracheal intubation (TE), various rectal procedures,
      removal of adhesive tapes, umbilical catheter (UK) insertion and removal, Various procedures
      such as aspiration, chest physiotherapy applications, diaper changing, various hand contacts,
      and general body care may induce pain responses in newborns. While these responses are
      associated with low cognitive and motor scores in early childhood, they may result in changes
      in visual-perceptual ability and somatosensory sensitivity later on. There are many studies
      in the literature to increase and prove the accuracy of pain assessment tools. However, since
      the pain treatments used in these studies were also varied, the homogeneity of the
      evaluations was insufficient. Therefore, more systematic evaluation studies should be
      conducted on how to improve pain management in NICUs. Finding which of the painful stimuli
      affects infants more will also guide the use of treatment methods. The aim of this study is
      to investigate the effects of different procedures applied in the NICU on the pain levels of
      term and preterm infants.
    

Observational model: Case-Only
Time perspective: Prospective
Sampling method: Probability Sample
Study population: 
        The study included 196 newborns who were hospitalized in SANKO University Hospital Level 3
        NICU and exposed to different painful procedures during routine clinical practices under
        Neonatologist follow-up.
      
Keywords: Newborn; pain; Preterm; Term; NICU