Background: We propose that neuroendocrine activity should be used as a `gold standard' for the assessment of prolonged pain and distress in the newborn.

Aim: An exploratory project to identify neuroendocrine markers of such pain /distress of babies in SE Scotland Regional Neonatal Unit.in Edinburgh

Patient groups: c=controls, p=pain (meningitis, early NEC, SAH, not requiring respiratory support, no significant physiological instability), d=distressed (respiratory support but not sedated, no known cause of pain). GA m 32.2w, PNA m 5.5d.

Measurements: 24 hour urine noradrenaline by HPLC. Salivary cortisol by RIA. Mann Whitney U test for sig. (p= 0.01* p= 0.04**)

Results: Table

Table 1
Full size table

CONCLUSIONS: Pain is a potent stimulus for adrenocortical activation. The physiological stress/psychological distress of respiratory disease or support may be a stimulus for sympathetic activation. We plan to use these laboratory findings to devise aclinical tool for pain assessment of the sick newborn.