Objective: In the neonatal intensive care unit (NICU), preterm infants are subject to environmental stress and numerous painful interventions. Recent researches suggest that preterm infants understand pain and stress. It is well known that untreated pain is associated with short and long term consequences during this critical period of brain development. Cranial ultrasound (CUS) examinations is one of intervention well known as a non-invasive and is routinely recommended as a screening procedure in preterm infants, especially those less than 32 weeks gestation, because they are at risk for intraventricular or intraparenchymal haemorrhage and for evidence of early white matter injury. According to this information, the present study is to evaluate if CUS examination causes any pain response in preterm infants.
Method: Subjects were preterm infants less than 32 weeks gestation who admitted to NICU at Dr. Soetomo Academic General Hospital, Surabaya in November 2018 until March 2019 who performed CUS for screening reason were included into this study. Their cranial were evaluated by ultrasound on day 3 after birth, which observed start on before, during and 5 minutes after the examination. Vital signs (heart rate, respiratory rate, transcutaneous oxygen saturation) were recorded. All subjects were also evaluated with Neonatal Infant Pain Scale (NIPS) during the examination.
Result: In this study, we evaluated 50 preterm infants. Subjects had, at birth, mean gestational age of 30.2 ± 1.4 weeks, birthweight of 1257 ± 238 grams. The heart rate (p 0.003), respiratory rate (p 0.004), and oxygen saturation (p 0.002) during the examination were significantly different than the values before and 5 minutes after the examination. These subjects have mean NIPS scores 3.1 ± 0.2.
Conclusion: Cranial ultrasound examination which is known as a non-invasive and painless intervention still causes significant pain in preterm infants.