Skip to main content

Pain and Oxidative Stress in Newborns

  • Chapter
  • First Online:
Perinatal and Prenatal Disorders

Abstract

Pain in newborns is a diffuse and severe problem, leading in some cases to threatening the integrity of their central nervous system. This risk is mediated by several events, among which is the production of free radicals (FR) induced by pain. Several studies show that FR are important in pain perception and that FR scavengers can antagonize pain perception. FR can be produced even by “minor” painful procedures. We do not know yet whether the amount of FR produced during a painful event is so high to put babies’ brain at risk, but this is a further alert to warn neonatal staff against pain induction in newborns; effective drugs and procedures exist to antagonize pain in newborns and their use is mandatory.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 129.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 169.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Anand KJ, Coskun V, Thrivikraman KV, Nemeroff CB, Plotsky PM. Long-term behavioral effects of repetitive pain in neonatal rat pups. Physiol Behav. 1999;66:627–37.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  2. Anand KJ, Scalzo FM. Can adverse neonatal experiences alter brain development and subsequent behavior? Biol Neonate. 2000;77:69–82.

    Article  CAS  PubMed  Google Scholar 

  3. Carbajal R, Rousset A, Danan C, Coquery S, Nolent P, Ducrocq S, Saizou C, Lapillonne A, Granier M, Durand P, Lenclen R, Coursol A, Hubert P, de Saint Blanquat L, Boëlle PY, Annequin D, Cimerman P, Anand KJ, Bréart G. Epidemiology and treatment of painful procedures in neonates in intensive care units. JAMA. 2008;300(1):60–70.

    Google Scholar 

  4. Blanquat L, Boëlle PY, Annequin D, Cimerman P, Anand KJ, Bréart G. Epidemiology and treatment of painful procedures in neonates in intensive care units. JAMA. 2008;300:60–70.

    Article  Google Scholar 

  5. Cignacco E, Hamers JP, Stoffel L, van Lingen RA, Schütz N, Müller R, Zimmermann LJ, Nelle M. Routine procedures in NICUs: factors influencing pain assessment and ranking by pain intensity. Swiss Med Wkly. 2008;138:484–91.

    PubMed  Google Scholar 

  6. Juul SE, Beyer RP, Bammler TK, Farin FM, Gleason CA. Effects of neonatal stress and morphine on murine hippocampal gene expression. Pediatr Res. 2011;69(4):285–92.

    Google Scholar 

  7. Grunau RE. Neonatal pain in very preterm infants: long-term effects on brain, neurodevelopment and pain reactivity. Rambam Maimonides Med J. 2013;29;4(4):e0025.

    Google Scholar 

  8. Currie JM. Stress and pain relief in the care of the surgical neonate. Semin Pediatr Surg. 2008;17:285–9.

    Article  PubMed  Google Scholar 

  9. Bellieni CV, Buonocore G. Neonatal pain treatment: ethical to be effective. J Perinatol. 2008;28:87–8.

    Article  CAS  PubMed  Google Scholar 

  10. Walker SM. Pain in children: recent advances and ongoing challenges. Br J Anaesth. 2008;101:101–10.

    Article  CAS  PubMed  Google Scholar 

  11. Anand KJ, Garg S, Rovnaghi CR, Narsinghani U, Bhutta AT, Hall RW. Ketamine reduces the cell death following inflammatory pain in newborn rat brain. Pediatr Res. 2007;62:283–90.

    Article  CAS  PubMed  Google Scholar 

  12. Anand KJ, Hickey PR. Pain and its effects in the human neonate and fetus. N Engl J Med. 1987;317:1321–9.

    Article  CAS  PubMed  Google Scholar 

  13. Bajic D, Commons KG, Soriano SG. Morphine-enhanced apoptosis in selective brain regions of neonatal rats. Int J Dev Neurosci. 2013;31(4):258–66.

    Google Scholar 

  14. Asmerom Y, Slater L, Boskovic DS, Bahjri K, Holden MS, Phillips R, Deming D, Ashwal S, Fayard E, Angeles DM. J Pediatr. 2013;163(1):29–35.e1.

    Google Scholar 

  15. Bhutta AT, Anand KJ. Vulnerability of the developing brain. Neuro Mech Clin Perinatol. 2002;29:357–72.

    Article  CAS  Google Scholar 

  16. Buonocore G, Perrone S, Longini M, Paffetti P, Vezzosi P, Gatti MG, Bracci R. Non protein bound iron as early predictive marker of neonatal brain damage. Brain. 2003;126:1224–30.

    Article  PubMed  Google Scholar 

  17. Mishra OP, Delivoria-Papadopoulos M. Cellular mechanisms of hypoxic injury in the developing brain. Brain Res Bull. 1999;48:233–8.

    Article  CAS  PubMed  Google Scholar 

  18. Goplerud JM, Mishra OP, Delivoria-Papadopoulos M. Brain cell membrane dysfunction following acute asphyxia in newborn piglets. Biol Neonate. 1992;61:33–41.

    Article  CAS  PubMed  Google Scholar 

  19. Palmer C, Menzies SL, Roberts RL, Pavlick G, Connor JR. Changes in iron histochemistry after hypoxic–ischemic brain injury in the neonatal rat. J Neurosci Res. 1999;56:60–71.

    Article  CAS  PubMed  Google Scholar 

  20. Saugstad OD. Oxidative stress in the newborn – a 30-year perspective. Biol Neonate. 2005;88:228–36.

    Article  CAS  PubMed  Google Scholar 

  21. Sorg O, Horn TFW, Yu NC, Gruol DL, Bloom FE. Inhibition of astrocyte glutamate uptake by reactive oxygen species: role of antioxidant enzymes. Mol Med. 1997;3:431–40.

    CAS  PubMed Central  PubMed  Google Scholar 

  22. Buonocore G, Perrone S, Longini M, Terzuoli L, Bracci R. Total hydroperoxide and advanced oxidation protein products in preterm hypoxic babies. Pediatr Res. 2000;47:221–4.

    Article  CAS  PubMed  Google Scholar 

  23. Buonocore G, Zani S, Perrone S, Caciotti B, Bracci B. Intraerythrocyte nonprotein-bound iron and plasma malondialdehyde in the hypoxic newborn. Free Radic Biol Med. 1998;25:766–70.

    Article  CAS  PubMed  Google Scholar 

  24. Dorrepaal CA, Berger HM, Benders MJN, van Zoeren-Grobben D, Van de Bor M, Van Bel F. Non protein-bound iron in postasphyxial reperfusion injury of the newborn. Pediatrics. 1996;98:883–9.

    CAS  PubMed  Google Scholar 

  25. Kaindl AM, Sifringer M, Koppelstaetter A, Genz K, Loeber R, Boerner C, Stuwe J, Klose J, Felderhoff-Mueser U. Erythropoietin protects the developing brain from hyperoxia-induced cell death and proteome changes. Ann Neurol. 2008;64:523–34.

    Article  CAS  PubMed  Google Scholar 

  26. Kakita H, Hussein MH, Daoud GA, Kato T, Murai H, Sugiura T, Mizuno K, Yamada Y, Ito T, Fukuda S, Kato I, Suzuki S, Togari H. Total hydroperoxide and biological antioxidant potentials in a neonatal sepsis model. Pediatr Res. 2006;60:675–9.

    Article  CAS  PubMed  Google Scholar 

  27. Ziskoven C, Jäger M, Zilkens C, Bloch W, Brixius K, Krauspe R. Oxidative stress in secondary osteoarthritis: from cartilage destruction to clinical presentation? Orthop Rev (Pavia). 2010;2(2):e23.

    Google Scholar 

  28. Rokyta R, Holecek V, Pekárkova I, Krejcová J, Racek J, Trefil L, Yamamotová A. Free radicals after painful stimulation are influenced by antioxidants and analgesics. Neuro Endocrinol Lett. 2003;24(5):304–9.

    Google Scholar 

  29. Kim HK, Zhang YP, Gwak YS, Abdi S. Phenyl N-tert-butylnitrone, a free radical scavenger, reduces mechanical allodynia in chemotherapy-induced neuropathic pain in rats. Anesthesiology. 2010;112(2):432–9.

    Google Scholar 

  30. Ohmichi Y, Sato J, Ohmichi M, Sakurai H, Yoshimoto T, Morimoto A, Hashimoto T, Eguchi K, Nishihara M, Arai YC, Ohishi H, Asamoto K, Ushida T, Nakano T, Kumazawa T. Two-week cast immobilization induced chronic widespread hyperalgesia in rats. Eur J Pain. 2012;16(3):338–48.

    Google Scholar 

  31. Choi JI, Kim WM, Lee HG, Kim YO, Yoon MH. Role of neuronal nitric oxide synthase in the antiallodynic effects of intrathecal EGCG in a neuropathic pain rat model. Neurosci Lett. 2012;510(1):53–7.

    Google Scholar 

  32. Mathew NT. Pathophysiology of chronic migraine and mode of action of preventive medications. Headache. 2011;51 Suppl 2:84–92.

    Google Scholar 

  33. Fricova J, Vejražka M, Stopka P, Krizova J, Běláček J, Rokyta R. The influence of pre-emptive analgesia on postoperative analgesia and its objective evaluation. Arch Med Sci. 2010;6(5):764–71.

    Google Scholar 

  34. Rokyta R, Stopka P, Holeček Křikava K, Pekárková I. Direct measurement of free radicals in the brain cortex and the blood serum after nociceptive stimulation. Neuro Endocrinol Lett. 2004;25:252–6.

    CAS  PubMed  Google Scholar 

  35. Păduraru I, Păduraru O, Manolidis G, Bild W, Haulică I. Antioxidant activity in rat models of nociceptive stress. Rev Med Chir Soc Med Nat Iasi. 2010;114(1):175–9.

    Google Scholar 

  36. Vaculin S, Franek M, Vejrazka M. Role of oxidative stress in animal model of visceral pain. Neurosci Lett. 2010;477(2):82–5.

    Google Scholar 

  37. Smith RP, Gitau R, Glover V, Fisk NM. Pain and stress in the human fetus. Eur J Obstet Gynecol Reprod Biol. 2000;92(1):161–5.

    Google Scholar 

  38. Collard CD, Gelman S. Pathophysiology, clinical manifestations, and prevention of ischemia-reperfusion injury. Anesthesiology. 2001;94(6):1133–8.

    Google Scholar 

  39. Johnson MA, Tekkanat K, Schmaltz SP, Fox IH. Adenosine triphosphate turnover in humans. Decreased degradation during relative hyperphosphatemia. J Clin Invest. 1989;84:990–5.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  40. Slater L, Asmerom Y, Boskovic DS, Bahjri K, Plank MS, Angeles KR, Phillips R, Deming D, Ashwal S, Hougland K, Fayard E, Angeles DM. Procedural pain and oxidative stress in premature neonates. J Pain. 2012;13(6):590–7.

    Google Scholar 

  41. Bhutta AT, Anand KJ. Vulnerability of the developing brain. Neuro Mech Clin Perinatol. 2002;29(3):357–72.

    Google Scholar 

  42. Wu LJ. Microglial voltage-gated proton channel Hv1 in ischemic stroke. Transl Stroke Res. 2014;5:99–108.

    Article  CAS  PubMed  Google Scholar 

  43. Bhutta AT, Anand KJ. Vulnerability of the developing brain. Neuro Mech Clin Perinatol. 2002;29:357–72.

    Google Scholar 

  44. Carbajal R, Rousset A, Danan C, Coquery S, Nolent P, Ducrocq S, Saizou C, Lapillonne A, Granier M, Durand P, Lenclen R, Coursol A, Hubert P, de Saint BL, Boëlle PY, Annequin D, Cimerman P, Anand KJ, Bréart G. Epidemiology and treatment of painful procedures in neonates in intensive care units. JAMA. 2008;300(1):60–70.

    Google Scholar 

  45. Perrone S, Tataranno LM, Stazzoni G, Ramenghi L, Buonocore G. Brain susceptibility to oxidative stress in the perinatal period. J Matern Fetal Neonatal Med. 2013 Aug 23. [Epub ahead of print].

    Google Scholar 

  46. Perrone S, Tataranno ML, Stazzoni G, Buonocore G. J Matern Fetal Neonatal Med. 2012;25(12):2575–8. Early identification of the risk for free radical-related diseases in preterm newborns.

    Google Scholar 

  47. Perrone S, Tataranno ML, Negro S, Longini M, Marzocchi B, Proietti F, Iacoponi F, Capitani S, Buonocore G. Early Hum Dev. 2010;86(4):241–4.

    Google Scholar 

  48. Bellieni CV, Iantorno L, Perrone S, Rodriguez A, Longini M, Capitani S, Buonocore G. Even routine painful procedures can be harmful for the newborn. Pain. 2009;147(1–3):128–31.

    Google Scholar 

  49. den Hengst WA, Gielis JF, Lin JY, Van Schil PE, De Windt LJ, Moens AL. Lung ischemia-reperfusion injury: a molecular and clinical view on a complex pathophysiological process. Am J Physiol Heart Circ Physiol. 2010;299(5):H1283–99.

    Google Scholar 

  50. Bellieni CV, Alagna MG, Buonocore G. Analgesia for infants’ circumcision. Ital J Pediatr. 2013;39:38. doi:10.1186/1824-7288-39-38.

  51. Bellieni CV, Tei M, Coccina F, Buonocore G. Sensorial saturation for infants’ pain. J Matern Fetal Neonatal Med. 2012;25 Suppl 1:79–81.

    Google Scholar 

Download references

Acknowledgment

Research support was provided by an unrestricted grant from the Italian Ministry of Health, Research Project RF-2009-1499651 – and Fondazione EURAIBI Onlus, Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Carlo V. Bellieni .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2014 Springer Science+Business Media New York

About this chapter

Cite this chapter

Bellieni, C.V., Buonocore, G. (2014). Pain and Oxidative Stress in Newborns. In: Dennery, P., Buonocore, G., Saugstad, O. (eds) Perinatal and Prenatal Disorders. Oxidative Stress in Applied Basic Research and Clinical Practice. Humana Press, New York, NY. https://doi.org/10.1007/978-1-4939-1405-0_16

Download citation

Publish with us

Policies and ethics