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Pain in Neonates and Infants 

Pain in Neonates and Infants
Pain in Neonates and Infants
Pain: Dynamics and Complexities

Daniel M. Doleys


A brief background noting a history of performing surgery on infants without the use of analgesics as it was thought they did not experience pain in the traditional sense is provided. The changing perception of pain in infants from ancient to contemporary times is outlined. The problem of assessing pain in the neonate and infant is addressed. The development of cortical connections begins at about 7.5 week of gestation. The best estimates suggest that it is about 30-weeks gestation before the connection from the periphery through the brain stem and thalamus on to the cortex is neurologically complete and potentially functional. Research exploring the development of the neurophysiological and neuroanatomical aspects the ‘pain processing’ system in animals and humans is summarized and suggest the presence of critical periods wherein certain physical and psychological traumas can cause permanent alterations. Exposing neonates or infants to certain types of noxious stimulation, such as injection, surgery, drawing of blood, etc., without adequate analgesia, may produce abnormal development of nociceptive neurons in the spinal cord rendering them more susceptible and hyper-responsive to pain as adults.

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