SKIN BLOOD-FLOW CHANGES DURING ROUTINE NURSERY PROCEDURES

Objective: The objective of this study was to establish that changes i n skin blood flow could serve as an index of pain and discomfort in ne wborn infants. Methods: Skin blood. flow changes during intensive care procedures and during morphine administration were measured in a grou p of newborn infants using a laser Doppler technique. Heart rate, resp iratory rate and oxygen saturation were also measured, Changes in skin blood flow and physiologic variables that occurred during procedures were analyzed and compared among procedures. Results: Measurements wer e made during 145 procedures in 15 infants 2-32 days old with birth we ights of 500-2900 g and gestational ages of 23-37 weeks, Ten of the in fants were receiving mechanical ventilation, Skin blood flow increased 27-134% during lancet puncture of the heel, physical handling, standa rd suctioning and chest physiotherapy, and there were no changes durin g closed system suctioning, Skin blood flow decreased 35% by 20 min af ter intravenous morphine, Changes seen in heart rate, respiratory rate and oxygen saturation were generally minimal, Conclusions: We conclud e that laser Doppler skin blood flow changes could be an index of neon atal pain and discomfort; even noninvasive handling procedures are ass ociated with increases in skin blood flow; and changes in skin blood f low may be more useful than conventional physiologic variables in asse ssing the response to intensive care nursery procedures.