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Evoked Potential as a Pain Evaluation Index for Neonatal Procedural Pain

Frequent pain has short- and long-term negative influences on the development of the brain and nerves and cognition, motion, and behavior of neonates. Neonates staying in the Neonatal Intensive Care Unit frequently receive painful procedures many times a day. Heel lance is one of the most frequently performed painful procedures for blood sampling, but the pain of heel lance has been not sufficiently managed for a long time. Due to the lack of the analgesic effect and safety of pharmacological intervention, the pain relief for neonatal heel lance is being searched for in diverse combinations of non-pharmacological interventions. To develop pain relief for the heel lance, the Premature Infant Pain Profile (PIPP) comprised of a mixture of physiological and behavioral indices is frequently used as a pain evaluation index, but several problems of PIPP have been pointed out with regard to neonatal pain evaluation, and pain evaluation using PIPP alone interferes with the development of pain relief for neonatal heel lance. Recently, evoked potentials (EP) after heel lance have been attracting attention as an index of evaluating pain objectively and quantitatively for neonates unable to express pain with words. EP detects more sharply pain stimulation and may enable continuous evaluation of neonatal pain along with growth and development. The development of EP-based pain evaluation promotes the development of pain relief for neonatal heel lance.