Neonatal pain Assessment scales: a review

Key words: Pain, Newborn infant, Pain assessment scales

Contrary to what was believed in the past, a newborn can experience pain. Anatomic structures involved in nociception are already mature at birth and now it is known that the recurrence of painful stimulations in a precocious period of brain development can alter the future processing of harmful stimuli. Nevertheless, the newborn’s pain is not easy to evaluate, because the neonate is a pre-verbal patient who cannot communicate their own pain but needs the assessment of an observer. For this reason, in recent years a lot of algometric scales have been developed, including both physiological and behavioural indicators; however, none of these scales has been recognized as the “gold standard”. The purpose of this review is to present the most important pain assessment scales (NFCS, EDIN, FLACC, COMFORT, CRIES, PIPP, and NIPS), in order to realize a simple and synthetic guide for their use in the clinical practice. The paper describes the context in which they have been validated and how they have been used subsequently, with the hope to raise interest in and draw attention to such an important matter.