Pain and heart rate variability in neonates receiving dexmedetomidine

IntroductionNeonates in a NICU experience pain. Based on the cardiovascular and nociceptive systems link, a Newborn Infant Parasympathetic Evaluation (NIPE) monitor was designed to assess pain. The use of alpha 2-agonists as analgesic-sedative drugs has increased in neonates. Given their effect on the autonomic system, we hypothesized that their use may alter NIPE's measurement capacity.MethodsData were prospectively collected. The included patients were evaluated using combined pain assessment systems.ResultsSixteen newborns requiring sedoanalgesia underwent a total of 84 pain assessments. A good correlation was found between the NIPE-index and the COMFORT-neo and the crSO2 (cerebral regional oxygen saturation). No correlation was found in premature infants. By sedation group, the correlation remained in those receiving alpha 2-agonist.ConclusionNIPE is a reliable tool for pain assessment. Further studies in premature infants are needed. The use of alpha 2-agonist does not alter the measuring capacity of NIPE. The correlation between NIPE-index and crSO2 was also demonstrated.