• B J Stevens, C C Johnston, and L Horton.
• Faculty of Nursing, University of Toronto, Ontario, Canada.
• J Obstet Gynecol Neonatal Nurs. 1993 Nov 1;22(6):531-41.

ObjectiveTo describe the physiologic and behavioral responses of premature neonates to a painful stimulus.DesignDescriptive.SettingSecondary-level neonatal unit in a large metropolitan university teaching hospital.ParticipantsForty neonates between 32 and 34 weeks' postconceptual age and less than 5 days' postnatal age.Main Outcome MeasuresPhysiologic (heart rate, oxygen saturation, and intracranial pressure) and behavioral (facial expression and cry) outcomes observed during a routine heel stick.ResultsPhysiologic responses were significant, but were not specific to pain. Behavioral responses were more promising and indicated that premature neonates were capable of responding in a manner similar to full-term neonates.ConclusionsPremature neonates are capable of expressing their pain in a manner similar to healthy, full-term neonates. Factors that alter this response were not clearly delineated. Further research is needed to determine more precise patterns of response in this age group.

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