Table 2a: Markers Used to Indicate Pain in Neonates

Cardiorespiratory
Increase in heart rate
Increase in blood pressure
Increase in respiratory rate
Fall in trancutaneous oxygen concentration
Sweat gland
Increase in palmar sweating
Increase in electrical conductance of the skin
Hormonal
Increased plasma concentrations
Cortisol
Catecholamines
Renin activity and aldosterone
Growth hormone
Glucagon
Suppression of insulin secretion
Behavioural
Changes in facial expression
Onset and duration of crying (or in some cases, stopping of crying)
Flexor withdrawal of limb

(Modified from Chiswick, 2000) [30].