Portex Unit: Pain Research, UCL Institute of Child Health, Great Ormond St Hospital for Children NHS Foundation Trust, 30 Guilford Street, London, UK.
Clin Perinatol. 2013 Sep;40(3):471-91. doi: 10.1016/j.clp.2013.05.002. Epub 2013 Jul 3.
Nociceptive pathways are functional following birth. In addition to physiological and behavioral responses, neurophysiological measures and neuroimaging evaluate nociceptive pathway function and quantify responses to noxious stimuli in preterm and term neonates. Intensive care and surgery can expose neonates to painful stimuli when the developing nervous system is sensitive to changing input, resulting in persistent impacts into later childhood. Early pain experience has been correlated with increased sensitivity to subsequent painful stimuli, impaired neurodevelopmental outcomes, and structural changes in brain development. Parallel preclinical studies have elucidated underlying mechanisms and evaluate preventive strategies to inform future clinical trials.
伤害性感受通路在出生后即开始发挥功能。除了生理和行为反应之外，神经生理学测量和神经影像学还可以评估伤害性感受通路的功能，并对早产儿和足月儿对有害刺激的反应进行量化。在发育中的神经系统对外界输入的变化非常敏感时，重症监护和手术可能会使新生儿接触到疼痛刺激，从而对以后的儿童期产生持久的影响。早期的疼痛体验与对后续疼痛刺激的敏感性增加、神经发育结局受损以及大脑发育结构变化有关。平行的临床前研究已经阐明了潜在的机制，并评估了预防策略，以为未来的临床试验提供信息。
