As it turns out, finishing the Anand and Hickey article, “Pain and its Effects in the Human Neonate and Fetus,” was relatively easy. The bulk of the chemistry and the neuroanatomy was contained in the first half of the piece, on which I reported in my blog post Feb. 10, 2013 “Just Above Water.” I feel relief and pride in having accomplished what I set out to do. Following is some startling material from the article and my responses to it.
“Tracheal intubation in awake preterm and full-term neonates* caused a significant decrease in transcutaneous partial pressure of oxygen, together with increases in arterial blood pressure and intracranial pressure” (6). — Imagine a tube being pushed into your throat without your having been anesthetized. Any wonder that stress caused physiological changes to take place? A baby would probably feel as though her life were threatened!
“Changes in patterns of neonatal cries have been correlated with the intensity of pain experienced during circumcision and were accurately differentiated by adult listeners. . . . neonates were found to be more sensitive to pain than older infants (those 3 to 12 months old)” (8). — Turns out that newborns are not just sensitive to pain but very sensitive!
“A recent controlled study showed that intervention designed to decrease the amount of sensory input and the intensity of stressful stimuli during intensive care of preterm neonates was associated with improved clinical and developmental outcomes. . . . the behavioral responses observed suggest that the neonatal response to pain is not just a reflex response” (9). — I want to say duh but am restraining myself. In order for the field of medicine to know something, measurements must be made. Data must be replicable. The scientific method is extremely important, but other ways of knowing should carry significant weight as well.
I am grateful that Anand and Hickey were able to prove scientifically what they observed–that infants suffered and often died from the uncontrolled pain and stress during and after surgeries and invasive medical procedures.