背景:胎儿疼痛的概念是由早产新生儿和胎儿在没有麻醉的情况下进行的手术引起的,这表明有可能根据应激激素检查胎儿疼痛,新陈代谢,和行为变化。解剖学和生理学数据表明,胎儿在妊娠中期变得能够处理伤害性刺激,尽管胎儿大脑发育的相关变化仍不清楚。根据国际疼痛研究协会(IASP)通过的疼痛定义,胎儿疼痛的构成仍然存在争议。这将疼痛视为一种“不愉快的感官和情感体验”。\"
结论:这里,我们研究了人类胎儿无法“体验”痛苦的概念以及这一说法的潜在含义。我们强调了与胎儿疼痛有关的关键科学证据,包括胎儿和早产新生儿疼痛的临床研究。我们认为压力荷尔蒙的一致模式,代谢变化,身体运动,血液动力学变化,暴露于侵入性程序的胎儿中与疼痛相关的面部表情克服了对IASP定义中所阐明的主观疼痛证明的需求。迄今为止,尚无任何研究最终证明超过存活年龄的胎儿疼痛不存在。
结论:根据目前的证据,我们建议所有的胎儿都接受麻醉,而不管正在进行的侵入性手术,以保证最小可能的疼痛和生理,行为,或荷尔蒙反应,而不会使母亲或婴儿遭受不必要的并发症。
BACKGROUND: The concept of fetal pain results from procedures conducted without anesthesia in preterm newborns and fetuses, which indicate that it is possible to examine fetal pain based on stress hormone, metabolic, and behavioral changes. Anatomical and physiological data suggest that fetuses become capable of processing nociceptive stimuli around midgestation, although the associated changes in fetal brain development remain unclear. What constitutes fetal pain remains controversial in the light of the definition of pain adopted by the International Association for the Study of Pain (IASP), which posits pain as an \"unpleasant sensory and emotional experience.\"
CONCLUSIONS: Here, we examine the notion that human fetuses cannot \"experience\" pain and potential implications of this claim. We highlight the key scientific evidence related to fetal pain, including clinical studies on pain in fetuses and preterm newborns. We argue that consistent patterns of stress hormones, metabolic changes, body movements, hemodynamic changes, and pain-related facial expressions in fetuses exposed to invasive procedures overcome the need for subjective proof of pain as articulated in the IASP definition. No study to date has conclusively proven the absence of fetal pain beyond the age of viability.
CONCLUSIONS: Based on the current evidence, we propose that all fetuses receive anesthesia regardless of the invasive procedures being performed to guarantee the least possible pain and physiological, behavioral, or hormonal responses without exposing the mother or her baby to unnecessary complications.