Pain in the Neonate

While pain control in children has been poor in the past, pain control in
neonates has been virtually neglected. In this review, I examine the rationalizations for not treating pain in
neonates, then discuss three areas where pain control needs improvement, specifically, in surgical anesthesia,
in analgesia for circumcision, and in analgesia following surgery. Suggestions are made for improving care in all
three spheres. One might suspect that in our current state of development of medical technology that children
and babies could be spared needless suffering from pain, but this is not the case. Pain in children is often
neglected in the clinical setting, and pain in the neonate is barely even mentioned in most textbooks or in the
medical literature. This lack of guidance for the practitioner is often rationalized by stating that neonates either
do not consciously perceive pain or, if they perceive pain, they do not remember it because of the immaturity of
their brain. Recently, however, it has become clear that neonates do sense pain, that physiologic changes occur
when neonates suffer pain, and that these physiologic changes can impede healing in small babies. This new
information, plus an awakening of concerns about humanitarian treatment of patients, has led to interest in
better management of pain in neonates.