A systematic review of the effects of repeated painful procedures in infants: Is there a potential to mitigate future pain responsivity?

Abstract

Background: Multiple lines of evidence suggest repeated painful procedures early in life may permanently disrupt the developing central nervous system. Painful diagnostic, medical, and minor surgical procedures performed in the neonatal intensive care unit such as venipunctures, heel lances, immunizations, and central venous catheter insertion are a significant portion of painful events experienced by infants. The objective of this systematic review is to synthesize findings from published clinical trials evaluating the effect of repeated painful procedures experienced during the plasticity of the developing peripheral and central nervous system and their influence on future pain responsivity.

Methodology/Principal Findings: A systematic review of peer-refereed clinical trials was conducted. Clinical trials examining the effect of repeated painful procedures experienced during the plasticity of the developing peripheral and central nervous system and their influence on future pain responsivity were identified from electronic databases PUBMED, MEDLINE and CINAHL. Application of inclusion/exclusion criteria and limitations identified five clinical trials for critical reviewed. Findings suggest that repetitive pain experienced during a critical window of neuro-
development alters the structure and function of an infant’s nervous system, influences subsequent pain responses through childhood and may contribute to the development of chronic pain.

Conclusions: Current research asserts that inadequate relief of infant pain and distress during tissue-damaging procedures may permanently decrease an individual’s pain tolerance, and increase pain responses later in life.