Suitable instruments for pain assessment at clinical neonatal settings need to be developed. The purpose of prospective study was to evaluate behavioral pain scales prior, during and after a painful procedure in clinically stable PT and healthy T neonates. 47 neonates without respiratory, cardiovascular, CNS diseases, congenital malformation and perinatal asphyxia were randomly assigned to receive capilar puncture-P (glycemia for PT and PKU screening for T) or alcohol swab friction-F. Patients were divided in 4 groups: PT-P (n=16; BW=2.1±0.5kg; GA=34±2w; 41±14h of life; 44% male); PT-F(n=12; BW=2.0±0.4kg; GA=34±1w; 36±8h of life; 42% male); T-P (n=10; BW=3.4±0.6kg; GA=39±1w; 34±6h of life; 60% male) and T-F (n=9; BW=3.3±0.4kg; GA=39±1w; 40±10h of life; 33% male). A neonatologist, blind to the procedure performed, evaluated Grunau & Craig pain features (G&C, 1987:0-8 pts; pain >2pts), Neonatal Infant Pain Scale (NIPS, 1994:0-7 pts; pain >3 pts), heart rate and O2 saturation by pulse-oximeter. All measurements were taken prior to P or F without (P-pr) and with foot heating (P-h), during, and 1′ and 3′ after the procedure. Results are in median (variation). Non-parametric statistic tests were performed with rejection level of 0.05.Table

Table 1
Full size table

Significantly more Term P neonates presented G & C >2 and NIPS >3 than F neonates (Fisher, p<.001). Heart rate and O2 saturation were similar between P and F groups at all study period for both T and PT infants(Mann-Whitney, p >.05).

This study clearly shows that G&C and NIPS are suitable instruments and should be utilized to evaluate pain in T neonates. G&C seems to differentiate better than NIPS, pain presence in PT neonates.