Background: In Sweden, all newborns are examined before discharge from the maternity ward to rule out innate abnormalities. Parts of this procedure, such as the hip examination, appear to cause pain and discomfort. Pain in newborns can have both short- and long-term negative consequences and preventing and treating pain is therefore an important part of medical care. There are several ways to recognize and assess pain in newborn infants. Scales such as the Premature Infant Pain Profile-Revised (PIPP-R) are recommended, but recently physiological and neurophysiological measures, e.g. Near-infrared spectroscopy (NIRS) and Galvanic Skin Response (GSR) have been suggested to have pain-assessing properties.
Aim: The aim of the study was to test the hypothesis that neonatal hip examination causes pain in newborns.
Method: The infant was placed on an examination table and a video camera was placed so the face of the newborn was filmed. A pulse oximeter probe, NIRS optodes and GSR electrodes were attached to the infant. Heart auscultation was chosen to be used as a non-painful comparative to hip examination.
Results: The results showed higher pain scoring for the hip examination than for the heart auscultation. NIRS, showed a significant difference in HbO2 on both sides of cortex. Mean PIPP-R went from 3.0 during the heart auscultation to 8.1 during the hip examination. GSR analyses showed significant increase in area under small peaks during the hip examination.
Conclusion: We conclude that neonatal hip examinations are painful and that the pain should be treated, e.g. with oral sweet solution.