The Association Between Physiological and Behavioral Pain Measures in 0- to 3-Year-Old Infants after Major Surgery

To estimate the association between behavioral and physiological pain measures and to identify determinants predicting the level of association, the COMFORT ‘behavior’ scale, heart rate (HR), mean arterial pressure (MAP), and the variability of HR and MAP (HRV and MAPV) were assessed every 3 hours a...

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Bibliographic Details
Published in:Journal of pain and symptom management 2001-07, Vol.22 (1), p.600-609
Main Authors: van Dijk, Monique, de Boer, Josien B, Koot, Hans M, Duivenvoorden, Hugo J, Passchier, Jan, Bouwmeester, Nancy, Tibboel, Dick
Format: Article
Language:English
Subjects:
Abdomen - surgery
Behavior–physiology association
Biological and medical sciences
Child Behavior - physiology
Child Behavior - psychology
Child, Preschool
Female
Humans
Infant
Infant Behavior - physiology
Infant Behavior - psychology
Infant, Newborn
Investigative techniques, diagnostic techniques (general aspects)
Male
Medical sciences
Miscellaneous. Technology
pain assessment
Pain Measurement
pain measures
Pain, Postoperative - physiopathology
Pain, Postoperative - psychology
Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques
pediatric pain
postoperative pain
Thoracic Surgical Procedures
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Summary:To estimate the association between behavioral and physiological pain measures and to identify determinants predicting the level of association, the COMFORT ‘behavior’ scale, heart rate (HR), mean arterial pressure (MAP), and the variability of HR and MAP (HRV and MAPV) were assessed every 3 hours after major abdominal or thoracic surgery. Subjects were 204 infants aged 0–3 years. The within-subject correlations, using the repeated measures, were 0.37, 0.44, 0.48, and 0.49 for COMFORT ‘behavior’ with HRV, HR, MAP, and MAPV, respectively. Neonates had lower behavior–physiology correlations than the older infants, due to low pain scores. Pain characteristics significantly predicted the COMFORT ‘behavior’-HR/MAP correlations, suggesting that the behavior–physiology correlations increase with increasing pain. The behavior–physiology correlations were not greatly affected by physical condition. These data demonstrate large interindividual differences in behavior–physiology correlations after major surgery in 0- to 3-year-old infants. These differences should be further explored in future research.
ISSN:0885-3924
1873-6513
DOI:10.1016/S0885-3924(01)00288-3