Better tools needed for assessing infant pain

Better tools needed for assessing infant pain Currently used pain assessment tools may be underestimating the pain response in infants according to a study published in the open access journal PLoS Medicine this week. Dr Slater and colleagues (University College London, UK) studied the association between cortical pain responses in young infants and currently used pain assessment tools which are based on behavioural and physiological measures, such as change in facial expression.

Evidence suggests that inadequate pain management in infants may have immediate and long-term effects. Repetitive pain in preterm infants has been associated with attention deficit disorder, learning disorders and behavioural problems in later childhood.

The researchers studied twelve clinically stable infants on 33 occasions when they required a heel lance for a clinical reason. The relationship between brain activity and a clinical pain score, calculated using the premature infant pain profile (PIPP), was examined in response to this painful event. They found that changes in brain activity correlated to the PIPP scores. These changes were more strongly linked to the behavioural components of the PIPP, e.g., facial expression, than physiological components, e.g., heart rate. They also observed no change in facial expression in 13 of the 33 test occasions but 10 of these showed a positive brain response.

While this was a small single-centre study on clinically stable infants, the results raise further awareness of the ability of infants to experience pain. And, as the authors say, the results highlight the possibility that "pain assessment based on behavioural tools alone should be interpreted with caution as they could under estimate the total pain response."

Citation: Slater R, Cantarella A, Franck L, Meek J, Fitzgerald M (2008) How well do clinical pain assessment tools reflect pain in infants? PLoS Med 5(6): e129.

PLEASE ADD THE LINK TO THE PUBLISHED ARTICLE IN ONLINE VERSIONS OF YOUR REPORT: http://medicine.plosjournals.org/perlserv/?request=get-document&doi=10.1371/journal.pmed.0050129

PRESS-ONLY PREVIEW OF THE ARTICLE: http://www.plos.org/press/plme-05-06-slater.pdf

CONTACT:
Rebeccah Slater
Neuroscience, Physiology and Pharmacology
University College London
Gower Street
London WC1E 6BT
United Kingdom
+44 20 7679 3386
r.slater@ucl.ac.uk

THE FOLLOWING RESEARCH ARTICLES WILL ALSO BE PUBLISHED ONLINE:

Educational video in clinic waiting rooms reduces new sexually transmitted infections

In a controlled trial at three sexually transmitted disease (STD) clinics in US cities, Lee Warner of the United States Centers for Disease Control and Prevention (CDC) and colleagues found that showing an STD prevention video in waiting rooms reduced new infections by nearly 10%.

Citation: Warner L, Klausner JD, Rietmeijer CA, Malotte CK, O'Donnell L, et al. (2008) Effect of a brief video intervention on incident infection among patients attending sexually transmitted disease clinics. PLoS Med 5(6): e135.

PLEASE ADD THE LINK TO THE PUBLISHED ARTICLE IN ONLINE VERSIONS OF YOUR REPORT: http://medicine.plosjournals.org/perlserv/?request=get-document&doi=10.1371/journal.pmed.0050135

PRESS-ONLY PREVIEW OF THE ARTICLE: http://www.plos.org/press/plme-05-06-warner.pdf

CONTACT:
Lee Warner
Centers for Disease Control and Prevention (CDC)
Division of HIV/AIDS Prevention
Atlanta, GA 30341
United States of America
+1 770-488-5989
dlw7@cdc.gov

A2BAR in renal protection from ischemia

Using gene-targeted mice, Holger Eltzschig (of the University of Colorado Health Sciences Center) and colleagues identify the A2B adenosine receptor as a novel therapeutic target for providing protection from renal ischemia.

Citation: Grenz A, Osswald H, Eckle T, Yang D, Zhang H, et al. (2008) The reno-vascular A2B adenosine receptor protects the kidney from ischemia. PLoS Med 5(6): e137.

PLEASE ADD THE LINK TO THE PUBLISHED ARTICLE IN ONLINE VERSIONS OF YOUR REPORT: http://medicine.plosjournals.org/perlserv/?request=get-document&doi=10.1371/journal.pmed.0050137

PRESS-ONLY PREVIEW OF THE ARTICLE: http://www.plos.org/press/plme-05-06-eltzschig.pdf

CONTACT:
Holger Eltzschig
University of Colorado Health Sciences Center
Mucosal Inflammation Program
Department of Anesthesiology and Perioperative Medicine
Biochemistry Research Building (BRB), Room 852
4200 E. 9th Ave, Mailstop B112
Denver, Colorado 80262
United States of America
+1 303-315-7320
+1 303-315-0369 (fax)
holger.eltzschig@uchsc.edu

Source: Public Library of Science