ROLE OF SUCROSE AND BREAST FEEDING FOR ANALGESIA IN NEWBORN INFANT UNDERGOING PAINFUL PROCEDURE A COMPARATIVE STUDY

Abstract

Pain is an unpleasant sensory and emotional experience associated with actual or potential tissuedamage .It is the basic right of every individual, irrespective of age or size to have alleviation of pain. Pain in newborn is an ubiquitous phenomenon. All newborns will experience iatrogenic pain in the first days of life, commencing with vitamin–k injection, sampling and metabolic screening.Pain may worsen already compromised physiological states like hypoxia, hypercarbia, acidosis, hyperglycemia or respiratory distress.Since neonates cannot verbalize pain,the recognition and management of pain in newborn babies is still suboptimal in NICU.Neonates do feel pain, and analgesia should be prescribed when indicated during medical care.Fetus is capable of mounting a stress response as early as 23 wks of gestation.Immature nervous system of preterm infantcan’t discriminate noxious and non-noxious stimuli react similarly to a variety of stimuli lack the ability to modulate pain response, doesn’t consistently manifest sign and symptoms. Infant cannot verbally report their level of pain. As per previous study neonatal response to painful stimuliwere decorticate in nature and perception,memories of pain was not present. Higher threshold of painful stimuli protects infant from pain following birth process.Relation between feeling pain and reporting pain are highly context dependent. Pain can be physiological,neuropathic,visceral and inflammatory or it may be like acute, established and chronic. Modification of pain system occurs in repetitive or prolonged pain due to altered processing in spinal and supraspinal region. Repeated painful stimuli increases the response of pain in future causing hyperalgesia and allodynia.To reduce the pain during procedure behavioral approach ,non-pharmacological approach ,pharmacological approach are the modalities. Manifestation of pain is detected by physiological, biochemical and behavioral changes. There are various tools to measure pain in neonate like NFCS(uni-dimentional),PIPP (acute pain),N-PASS (prolonged pain),NIPS(neonatal infant pain score), CRIES (cry require oxygen,increase vital sign,expression,sleeplessness).COMFORT scale.