Sensitivity and Specificity of the Newborn Infant Parasympathetic Evaluation Index in Pain Assessment of Very Low Birth Weight Infants

Abstract

Objective This article describes the results of a study investigating the sensitivity and specificity of the Newborn Infant Parasympathetic Evaluation (NIPE) index for detecting the physiological changes resulting from nociception in painful procedures in very low birth weight (VLBW) infants.

Study Design A prospective observational study was carried on of 44 newborns at 23 to 32 weeks' gestational age. The sensitivity and specificity of the NIPE index are analyzed using a receiver operating characteristic curve. Most of the painful procedures performed were skin-lancing and venipunctures. Nonpainful procedures consist of no intervention, with an interval of at least 1 hour with painful procedures in each newborn.

Results The accuracy of the NIPE index to diagnose mild nociceptive stimulation in VLBW newborns is 73.2%.

Conclusion The NIPE index is a useful technique for assessing nociceptive stimulation in newborns, presenting less observer-dependent variability than other pain assessment scales.

Key Points

• The NIPE index offers an objective assessment of pain.

• Moderate-high sensitivity of the NIPE index in the evaluation of pain in premature newborns.

• Painful procedures in VLBW newborns are reflected as a decrease in the NIPE score.

Keywords

pain - newborn - premature infant - Newborn Infant Parasympathetic Evaluation - Premature Infant Pain Profile

Statement of Compliance with Research Ethics Codes

The authors declare that the work presented in this manuscript is original and is not currently being evaluated by any other journal. The authors have no relevant conflicts of interest to declare. The consent of the parents or guardian of the patients was required. The study protocol was approved by the Ethics Committee of the hospital, and all current regulations regarding data confidentiality were respected.

Authors' Contributions

J.U. designed the analysis and data interpretation procedures, co-wrote the article, and critically reviewed it for important intellectual content. He approves the present version for publication. He accepts responsibility for all aspects of the work, including the proper investigation and resolution of questions related to its accuracy and completeness. J.L.G.-S., A.C.-M., E.F.-M., and A.R.-L. made substantial contributions to the conception and design of the study, co-wrote the article, and critically reviewed it for important intellectual content. They approve the present version for publication. They accept responsibility for all aspects of the work, including the proper investigation and resolution of questions related to its accuracy and completeness.

Publication History

Received: 21 March 2022

Accepted: 21 June 2022

Article published online:
30 November 2022

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