In childhood the response changes towards the adult pattern. Early exposure to pain can profoundly affect subsequent behaviour and response to analgesics. Patients undergoing neonatal circumcision without analgesia had altered behavioural response to pain even 6 months later. The application of topical EMLA cream at circumcision could partially prevent this hipersensitivity. Brain maturation and emotional development significantly affect pain behaviour and must be taken into account in methods of pain management.
Preterm infant has complex interneuronal connections but different from term infants.
Their responses are exaggerated but not as discriminative, with larger receptive fields, increased sensitivity and a tendency to hypersensitization. Haemodynamic responses to fetal surgery occur as early as 18 weeks gestation. It is now accepted that for humanitarian, ethical and physiological reasons, pain should be anticipated and safely and effectively controlled in all children, whatever their age, maturity or severity of illness. Pain Assessment Pain is a subjective experience, and the child should be respected as an authority on their own pain. However, pain perception includes not only the sensory responses associated with a noxious stimuli but also individual factors for each child.