A preterm infant has just been admitted to the neonatal intensive care unit. The infant's parents ask the nurse about anesthesia and analgesia when painful procedures are necessary. What should the nurse's explanation be?
a. Nerve pathways of neonates are not sufficiently myelinated to transmit painful stimuli.
b. The risks accompanying anesthesia and analgesia are too great to justify any possible benefit of pain relief.
c. Neonates do not possess sufficiently integrated cortical function to interpret or recall pain experiences.
d. Pain pathways and neurochemical systems associated with pain transmission are intact and functional in neonates.
ANS: D
Pain pathways and neurochemical systems associated with pain transmission are intact and functional in neonates. Painful stimuli cause a global stress response, including cardiorespiratory changes, palmar sweating, increased intracranial pressure, and hormonal and metabolic changes. Adequate analgesia and anesthesia are necessary to decrease the stress response. The pathways are sufficiently myelinated to transmit the painful stimuli and produce the pain response. Local and systemic pharmacologic agents are available to permit anesthesia and analgesia for neonates.
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