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Query: UMLS:C0029713 (immaturity)
 4,335 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Pain in neonates and children differs to that in adults. One of the many challenges associated with the diagnosis and management of pain in early life is that neonates are non-verbal and therefore incapable of communicating their pain effectively to their caregivers. Early life pain is characterised by lowered thermal and mechanical thresholds, and exaggerated and often inappropriate behavioural reactions to pain. These differing behavioural reactions are underpinned by increased excitability/decreased inhibition within the spinal dorsal horn. This itself is the result of immaturity in the anatomical expression of key neurotransmitters and neuromodulators within spinal pain circuits, as well as decreased inhibitory input to these circuits from brainstem centres, and an immature relationship between neuronal and non-neuronal cells which affects pain response. These differences between early and adult pain impact upon not just acute reactions to pain, but also the incidence, severity and duration of chronic pain. In this chapter, chronic pain in childhood is discussed, as are the structural and functional differences that underpin differences in acute pain processing between adults and children. The ability of pain that occurs in early life to alter life-long pain responding is also addressed.
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PMID:Acute and chronic pain in children. 2501 10

Modern health care has brought our society innumerable benefits but has also introduced the experience of pain very early in life. For example, it is now routine care for newborns to receive various injections or have blood drawn within 24 h of life. For infants who are sick or premature, the pain experiences inherent in the required medical care are frequent and often severe, with neonates requiring intensive care admission encountering approximately fourteen painful procedures daily in the hospital. Given that much of the world has seen a steady increase in preterm births for the last several decades, an ever-growing number of babies experience multiple painful events before even leaving the hospital. These noxious events occur during a critical period of neurodevelopment when the nervous system is very vulnerable due to immaturity and neuroplasticity. Here, we provide a narrative review of the literature pertaining to the idea that early life pain has significant long-term effects on neurosensory, cognition, behavior, pain processing, and health outcomes that persist into childhood and even adulthood. We refer to clinical and pre-clinical studies investigating how early life pain impacts acute pain later in life, focusing on animal model correlates that have been used to better understand this relationship. Current knowledge around the proposed underlying mechanisms responsible for the long-lasting consequences of neonatal pain, its neurobiological and behavioral effects, and its influence on later pain states are discussed. We conclude by highlighting that another important consequence of early life pain may be the impact it has on later chronic pain states-an area of research that has received little attention.
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PMID:Early Neonatal Pain-A Review of Clinical and Experimental Implications on Painful Conditions Later in Life. 3211 35