Project 467157

Preterm infants (37 weeks gestational age [GA]) in the neonatal intensive care unit (NICU) are exposed to 8-17 invasive procedures daily to manage their life-threatening conditions. These invasive procedures are sources of stress and pain, which may deleteriously impact critical phases of brain development. To protect babies development by implementing effective pain management strategies, pain must be accurately assessed. Pain is challenging to study because these vulnerable babies cannot communicate verbally and have underdeveloped nervous systems. The standard care pain assessment tool used in BC Womens Hospital (BCWH) is the Behavioural Indicators of Infant Pain (BIIP). Studies have shown that noxious stimuli in infants are associated with cortical electrical and hemodynamic changes in the brain, which can be measured with electroencephalography (EEG) and near-infrared spectroscopy (NIRS). This pilot study aims to examine the relationship between cerebral electrical/hemodynamic changes and behavioural responses during a noxious stimulus (heel lance for blood procurement). To conduct this study, EEG/NIRS response and BIIP scores from 10 infants between 27-36+6 weeks GA in the BCWH NICU will be collected during baseline, touch, heel lance, and recovery; clinical data will also be collected from charts to explore possible confounding factors and compare measurable differences. This pilot study will elucidate the correlation between changes in cerebral electrical/hemodynamic and behavioural pain responses to a common painful procedure in preterm infants. Results from this study will further evaluate the validity of behavioural pain measures and continue to move forward our understanding of preterm infants pain responses.