Studies have clearly shown that development of pain receptors starts as early as 20-weeks’ gestation. Despite contrary belief, the human fetus develops a similar number of receptive pain fibers as seen in adults. These receptors' maturation is based on response to sensory stimuli received after birth which makes the NICU a critical place for developing central nervous system's pain perception. In practice, the assessment of pain relies mostly on bedside staff. In this review we will discuss the various developing features of pain pathways in the neonatal brain and the modification of pain perception secondary to various interactions immediately after birth. We also discuss the various tools utilized in the NICU for pain assessment that rely on physiological and behavioral patterns. Finally, we address the management of pain in the NICU by either pharmacological or non-pharmacological intervention while highlighting potential benefits, disadvantages, and situations where one may be preferred over another.

研究清楚地表明，疼痛感受器早在妊娠 20 周时就开始发育。尽管有相反的看法，人类胎儿发育出与成人相似数量的感受性疼痛纤维。这些受体的成熟基于对出生后收到的感觉刺激的反应，这使得新生儿重症监护室成为发展中枢神经系统疼痛感知的关键场所。在实践中，疼痛的评估主要依赖于床边工作人员。在这篇综述中，我们将讨论新生儿大脑中疼痛通路的各种发展特征，以及出生后立即发生的各种相互作用继发的疼痛知觉的改变。我们还讨论了 NICU 中使用的各种依赖于生理和行为模式的疼痛评估工具。最后，我们通过药物或非药物干预来解决新生儿重症监护病房的疼痛管理问题，同时强调潜在的好处、缺点以及一种可能优于另一种的情况。