Pain in newborns and prematures: current practice and knowledge.

No unambiguous answer can be given as to whether newborns are able to feel pain similar to that experienced by older children and adults. However, there are several lines of evidence--anatomical, physiological and behavioral--which substantiate the possible presence of distressing nociceptive activity in the full-term and preterm neonate. Although the efficacy and safety of anesthesia in newborns and prematures has repeatedly been demonstrated, there are still numerous recommendations and current practices, based on antiquated theories, that withhold adequate medications from neonates during surgery. Even if the emotional and cognitive aspects of nociception in the newborn remain a subject of speculation giving rise to philosophical discussions as to the correct terminology, it is the mandate of newborns' physicians to provide the best possible therapy to their patients and to protect them from distress, unease and presumptive pain.