Due to the subtlety or absence of predictable, objective signs of pain in critically ill infants, health care professionals must often rely on observations of behavioural or nonspecific physiological signals. Although parameters such as heart rate or blood pressure could be regarded as relatively more objective or quantifiable measures than behavioural signals, they are often unstable and generally nonspecific. However, reducing inaccuracies in pain assessment and misinterpretation of pain intensity may be facilitated by new techniques that shed light on the cerebral responses to pain that could be measured directly. Near-infrared spectroscopy is one such technique that has been used to detect subtle changes in the concentrations of oxygenated and deoxygenated hemoglobin in the brains of preterm and term infants in response to stressful and/or painful stimuli. Following a review of cortical pain responses, this article provides an overview of near-infrared spectroscopy technology and its use in functional activation studies in critically ill infants, and its potential applications in clinical settings and pain research.Signs of pain may be subtle or absent in a critically ill infant. The complex nature of pain may further obscure its identification and measurement. Because the use of monitoring and neuroimaging techniques has become more common in pain research, an understanding of these specialized technologies is important. Near-infrared spectroscopy (NIRS) is a noninvasive technique for monitoring tissue hemodynamics and oxygenation. There are indications that NIRS is capable of detecting the cerebral hemodynamic changes associated with sensory stimuli, including pain, in infants. These developments suggest that NIRS may play an important role in research focusing on pain perception in critically ill infants. The present review briefly describes the cortical responses to noxious stimuli, which parallel cerebral hemodynamic responses to various stimuli. This is followed by an overview of NIRS technology including a summary of the literature on functional studies that have used NIRS in infants. Current NIRS techniques have well-recognized limitations that must be considered carefully during the measurement and interpretation of the signals. Nonetheless, until more advanced NIRS techniques emerge, the current devices have strengths that should be exploited.

中文翻译：

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脑近红外光谱法作为重症III型婴儿伤害性诱发活动的一种量度

由于危重症婴儿的疼痛微妙或缺乏可预见的客观疼痛迹象，医疗保健专业人员必须经常依靠对行为或非特异性生理信号的观察。尽管可以将诸如心率或血压之类的参数视为比行为信号更为客观或可量化的指标，但它们通常是不稳定的并且通常是非特异性的。但是，可以通过新技术来减轻疼痛评估中的不准确性和对疼痛强度的误解，这些新技术可以揭示可直接测量的对疼痛的大脑反应。近红外光谱法是一种这样的技术，其已被用于检测早产和足月婴儿的大脑中对应激和/或疼痛刺激作出反应的含氧和脱氧血红蛋白浓度的细微变化。在回顾了皮层疼痛反应后，本文概述了近红外光谱技术及其在危重婴儿功能激活研究中的应用以及在临床环境和疼痛研究中的潜在应用。疼痛的迹象可能不明显或不存在。在重病婴儿中。疼痛的复杂性可能会进一步掩盖其识别和测量。由于在疼痛研究中使用监视和神经影像技术已变得越来越普遍，因此对这些专门技术的理解非常重要。近红外光谱法（NIRS）是一种用于监测组织血流动力学和氧合的非侵入性技术。有迹象表明，NIRS能够检测婴儿与感觉刺激（包括疼痛）相关的脑血流动力学变化。这些进展表明，NIRS可能在重症婴儿的疼痛感知研究中发挥重要作用。本综述简要描述了对有害刺激的皮层反应，该反应与大脑对各种刺激的血液动力学反应平行。接下来是对NIRS技术的概述，包括有关在婴儿中使用NIRS的功能研究文献的摘要。当前的NIRS技术具有公认的局限性，在信号的测量和解释过程中必须仔细考虑这些局限性。尽管如此，