Abstract
Pain assessment in newborns is a widely debated topic. There are currently various methods of evaluating pain intensity in subjects who cannot express themselves in words, since pain can be assessed indirectly through the increase in plasma β-endorphin and catecholamines before and after pain, and through analysis of facial expression and complex movements of the extremities and of the changes in parameters such as oxygen saturation of the blood, heart rate and sweating of the palms. More than 30 neonatal pain scales exist, but almost none is actually used in clinical settings. Many of them are multifactorial, i.e. they simultaneously take account of fluctuations in oxygen saturation, blood pressure, and facial expression, but also score gestational age, behaviour and so on [1–9]. The more complex scales are good for research purposes, but only if we record the procedure in order to give the scorers the opportunity to assess the requested items in a later session. The most widely used are the PIPP (Premature Infant Pain Profile), NIPS (Neonatal Infant Pain Scale) and DAN (Douleur Aiguë du Nouveau-né) (see Chap. 9).
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Franck LS, Greenberg CS, Stevens B (2000) Pain assessment in infants and children. Pediatr Clin North Am 47:487–512
Carbajal R, Paupe A, Hoenn E et al (1997) DAN: une échelle comportamentale d’évaluation de la douleur aiguë du nouveau-né. Arch Pediatr 4:623–628
Grunau RVE, Craig KD (1987) Pain expression in neonates: facial action and cry. Pain 28:395–410
Stevens B, Johnston C, Petryshen P, Taddio A (1996) Premature infant pain profile: development and initial validation. Clin J Pain 12:13–22
Krechel SW, Bildner J (1995) Cries: a new neonatal postoperative pain measurement score. Initial testing of validity and reliability. Pediatr Anaesth 5:53–61
Marceau J (2003) Pilot study of a pain assessment tool in the Neonatal Intensive Care Unit. J Paediatr Child Health 39:598–601
Peters JW, Koot HM, Grunau RE et al (2003) Neonatal facial coding system for assessing postoperative pain in infants: item reduction is valid and feasible. Clin J Pain 19:353–363
Guinsburg R, de Almeida MF, de Araujo Peres C et al (2003) Reliability of two behavioral tools to assess pain in preterm neonates. Sao Paulo Med J 121:72–76
Manworren RC, Hynan LS (2003) Clinical validation of FLACC: preverbal patient pain scale. Pediatr Nurs 29:140–146
Bellieni CV, Cordelli DM, Caliani C et al (2007) Inter-observer reliability of two pain scales for newborns. Early Hum Dev 83:549–552
Barr RG, Hopkins B, Green JA (2000) Crying as a sign, a symptom and a signal: evolving concepts of crying behavior. In: Barr RG, Hopkins B, Green JA (eds) Crying as a sign, a symptom and a signal. Cambridge University Press, Cambridge, pp 1–7
Choonara I (1999) Why do babies cry? BMJ 319:1381
Fuller BF (1991) Acoustic discrimination of three types of infant cries. Nurs Res 40:156–160
Gustafson GE, Wood RM, Green JA (2000) Can we hear the causes of infants’ crying? In: Barr RG, Hopkins B, Green JA (eds) Crying as a sign, a symptom and a signal. Cambridge University Press, Cambridge, pp 8–22
Porter FL, Miller RH, Marshall RE (1986) Neonatal pain cries: effect of circumcision on acoustic features and perceived urgency. Child Dev 57:790–802
Wood RM, Gustafson GE (2001) Infant crying and adults’ anticipated caregiving responses: acoustic and contextual influences. Child Dev 72:1287–1300
Corwin MJ, Lester BM, Golub HL (1996) The infant cry: what can it tell us? Curr Probl Pediatr 26:325–334
Zeskind PS, Marshall TR (1988) The relation between variations in pitch and maternal perceptions of infant crying. Child Dev 59:193–196
Lester BM, Boukydis CF, Garcia-Coll CT et al (1995) Developmental outcome as a function of the goodness of fit between the infant’s cry characteristics and the mother’s perception of her infant’s cry. Pediatrics 95:516–521
Stevens B, Johnston CC, Petryshen P, Taddio A (1996) Premature infant pain profile: developmental and initial validation. Clin J Pain 12:13–22
Grunau RVE, Oberlander TF, Holsti L (1998) Bedside application of the neonatal facial coding system in pain assessment of premature neonates. Pain 76:277–286
Lawrence J, Alcock D, McGrath P et al (1993) The development of a tool to assess neonatal pain. Neonatal Netw 12:59–66
Sparshott M (1996) The development of a clinical distress scale for ventilated newborn infants: identification of pain based on validated behavioural scores. J Neonatal Nurs 2:5–11
Craig KD, Gilbert-Mac Leod CA, Lilley CM (2000) Crying as an indicator of pain in infants. In: Barr RG, Hopkins B, Green JA (eds) Crying as a sign, a symptom and a signal. Cambridge University Press, Cambridge, pp 23–40
Gallo AM (2003) The fifth vital sign: implementation of the Neonatal Infant Pain Scale. J Obstet Gynecol Neonatal Nurs 32:199–206
Gorski P (1984) Experiences following premature birth: stresses and opportunities for infants, parents and professionals. In: Call DJ, Galenson E, Tyson RL (eds) Frontiers of infant psychiatry. Basic Books, New York, pp 145–151
Wesz-Hockert W, Partanen T, Vuorenkoski V et al (1964) Effect of training on ability to identify preverbal vocalizations. Dev Med Child Neurol 6:393–396
Porter F (1989) Pain in the newborn. Clin Perinatol 16:549–1993
Johnston CC, Strada ME (1986) Acute pain response in infants: a multidimensional description. Pain 24:373–382
Bellieni CV, Sisto R, Cordelli DM, Buonocore G (2004) Cry features reflect pain intensity in term newborns: an alarm threshold. Pediatr Res 55:142–146
Zeskind PS, Parker-Price S, Barr RG (1993) Rhythmic organization of the sound of infant crying. Dev Psychobiol 26:321–333
Hooper SL (2000) Central pattern generators. Curr Biol 10:R176
Bellieni CV, Bagnoli F, Sisto R et al (2005) Development and validation of the ABC pain scale for healthy full-term babies. Acta Paediatr 94:1432–1436
Schollin J (2005) Can cry in the newborn be used as an assessment of pain? Acta Paediatr 94:1358–1360
Bellieni CV, Maffei M, Ancora G et al (2007) Is the ABC pain scale reliable for premature babies? Acta Pediatr (in press)
Sisto R, Bellieni CV, Perrone S, Buonocore G (2006) Neonatal pain analyzer: development and validation. Med Biol Eng Comput 44:841–845
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2008 Springer
About this chapter
Cite this chapter
Bellieni, C.V., Buonocore, G. (2008). Pain Assessment and Spectral Analysis of Neonatal Crying. In: Buonocore, G., Bellieni, C.V. (eds) Neonatal Pain. Springer, Milano. https://doi.org/10.1007/978-88-470-0732-1_9
Download citation
DOI: https://doi.org/10.1007/978-88-470-0732-1_9
Publisher Name: Springer, Milano
Print ISBN: 978-88-470-0731-4
Online ISBN: 978-88-470-0732-1
eBook Packages: MedicineMedicine (R0)