A REVISED MEASURE OF ACUTE PAIN IN INFANTS

Acute pain in infants is not assessed or managed optimally. The object ives of the study were (a) to adapt a behavioral pain assessment measu re (Children's Hospital of Eastern Ontario Pain Scale, CHEOPS) for use with infants, and (b) to establish the reliability and validity of th e measure in a study of infants undergoing immunization. Ninety-six he althy 4- to 6-month-old infants were randomized to receive either the local anesthetic cream Eutectic Mixture of Local Anesthetics (EMLA) (N = 49), or a placebo (N = 47) prior to immunization. The infant's beha vioral response was videotaped immediately before and following the im munization. Postprocedural pain scores were assessed from the videotap e and were significantly lower in infants who received EMLA (P = 0.01) . Pain scores were also significantly correlated with visual analogue scale (VAS) scores assessed during vaccination. Five independent rater s also independently rated ten infants to determine interrater reliabi lity. Agreement between raters' scores was high (intraclass correlatio n coefficient 0.95). Results from this study suggest that this measure has beginning construct and concurrent validity and interrater reliab ility when used in a research study. Further testing of the measure in the clinical setting is required.