Kabra N S, Udani R H
Department of Neonatology, Seth G.S. Medical College, Parel, Mumbai.
Indian J Pediatr. 1999 Jan-Feb;66(1):121-30. doi: 10.1007/BF02752369.
Anatomical, functional and neurochemical maturation of pain pathways is well developed in fetus and neonates. Various physiological and behavioural responses to painful stimuli in neonates substantiate their ability to feel pain. Biological effects of pain are systematically studied in human fetus and neonates. Pain expressions in the newborn not only reflect tissue damage but are a function of ongoing behavioural state. The ultimate aim should be to keep neonates free from pain and other stressful stimuli as far as possible, by advocating minimal handling protocol, giving comforts after painful procedures, local anesthesia while carrying out painful procedures like cutdown and insertion of chest tubes, and if a baby is ventilated fentanyl and/or midazalam infusion must be carried out during initial periods of ventilation.
疼痛通路的解剖学、功能和神经化学成熟在胎儿和新生儿中发育良好。新生儿对疼痛刺激的各种生理和行为反应证实了他们感受疼痛的能力。在人类胎儿和新生儿中系统地研究了疼痛的生物学效应。新生儿的疼痛表现不仅反映组织损伤,而且是当前行为状态的一种功能。最终目标应该是通过提倡最小化操作方案、在疼痛操作后给予安抚、在进行如切开和插入胸管等疼痛操作时进行局部麻醉,以及如果婴儿接受机械通气,在通气初期必须进行芬太尼和/或咪达唑仑输注,尽可能使新生儿免受疼痛和其他应激刺激。