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

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