Title

Exploring the association between pain intensity and facial display in term newborns

Authors

Authors

M. Schiavenato; M. Butler-O'Hara;P. Scovanner

Comments

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Abbreviated Journal Title

Pain Res. Manag.

Keywords

Computer measurement; Facial expression; Neonatal pain; Point-pair; method; Primal face of pain; PRIMAL FACE; EXPRESSION; RESPONSES; INFANTS; SCALE; CRY; Clinical Neurology

Abstract

BACKGROUND: Facial expression is widely used to judge pain in neonates. However, little is known about the relationship between intensity of the painful stimulus and the nature of the expression in term neonates. OBJECTIVES: To describe differences in the movement of key facial areas between two groups of term neonates experiencing painful stimuli of different intensities. METHODS: Video recordings from two previous studies were used to select study subjects. Four term neonates undergoing circumcision without analgesia were compared with four similar male term neonates undergoing a routine heel stick. Facial movements were measured with a computer using a previously developed 'point-pair' system that focuses on movement in areas implicated in neonatal pain expression. Measurements were expressed in pixels, standardized to percentage of individual infant face width. RESULTS: Point pairs measuring eyebrow and eye movement were similar, as was the sum of change across the face (41.15 in the circumcision group versus 40.33 in the heel stick group). Point pair 4 (horizontal change of the mouth) was higher for the heel stick group at 9.09 versus 3.93 for the circumcision group, while point pair 5 (vertical change of the mouth) was higher for the circumcision group (23.32) than for the heel stick group (15.53). CONCLUSION: Little difference was noted in eye and eyebrow movement between pain intensities. The mouth opened wider (vertically) in neonates experiencing the higher pain stimulus. Qualitative differences in neonatal facial expression to pain intensity may exist, and the mouth may be an area in which to detect them. Further study of the generalizability of these findings is needed.

Journal Title

Pain Research & Management

Volume

16

Issue/Number

1

Publication Date

1-1-2011

Document Type

Article

Language

English

First Page

10

Last Page

12

WOS Identifier

WOS:000287605900001

ISSN

1203-6765

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