Pain and Its Effects in the Human Neonate and Fetus
New England Journal of Medicine. 1987 Nov 19; 317(21): 1321-1329.
The authors, from the Anesthesia Department of the Harvard Medical School, review the literature on pain in the developing fetus and the newborn: the anatomical and functional requirements for pain perception; its associated neurochemical systems; and the physiological and behavioral changes, including memory, associated with pain. They present evidence that suggests that the anatomical structures and neurochemical systems associated with pain transmission and perception are functioning in late gestation. In newborns, physiologic responses to painful stimuli are well documented and other responses are suggestive of integrated emotional and behavioral responses that are retained in memory long enough to modify subsequent behavior patterns. The authors conclude that humane care for newborns and infants requires the evaluation of the risks and benefits of analgesia and anesthesia during painful and stressful procedures. (KIE abstract)
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