Which of the following CORRECTLY identifies a difference between neonatal and adult pain perception?

a) Neonates have decreased density of peripheral nociceptors compared to adults

b) Neonates have decreased pain signal modulation at the spinal cord level (compared to adults)

c) Neonatal ascending spinothalamic tracts are incompletely myelinated

d) Neonates have an enhanced descending pain-perception inhibition system.

e) Neonatal pain desensitizes the infant to painful stimuli later in life

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Answer

Answer c. Despite the incomplete myelination and increased signal modification, the developing nervous system of the neonate is able to detect pain with an increased density of peripheral nociceptors and a less-developed descending inhibitory system. Importantly, exposure to pain early in life (once thought to be irrelevant due to immature pathways) is believed to sensitize the child to future pain by altering the development of the pain pathways.

Notes

This question originally printed in the Pediatric Anesthesiology Review Topics kindle book series, and appears courtesy of Naerthwyn Press, LLC.

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