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Long-term effects of pain in children 

Long-term effects of pain in children
Long-term effects of pain in children

Ruth E. Grunau

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date: 16 September 2021

Major advances in high-technology medical care have led to greatly increased survival of medically fragile infants born extremely preterm, or with major congenital anomalies or other life-threatening conditions. These infants are exposed to procedural, surgical, and post-surgical pain. For millennia human infancy was a prolonged period of adult protection, with pain rarely encountered early in life. While the biological mechanisms for perception of pain develop during the fetal period, endogenous capacities to dampen pain mature later. Until relatively recently, this biological substrate was a good fit, matching the environment of infancy. However, the revolution in medical care has led to unforeseen challenges to understand and manage infant pain. In full-term infants, the primary concern is whether early pain alters later pain sensitivity. In contrast, due to the immaturity of the developing nervous system, the greatest impact of pain is likely to occur in the least maturely born infants. Therefore, in infants born very preterm who undergo lengthy hospitalization, pain may affect multiple aspects of development. This chapter focuses on long-term effects of early pain on subsequent pain perception, neurodevelopment, brain development, and programming of stress systems in the context of clinical studies, and whether caregiving factors may ameliorate potential long-term adverse effects.

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