Table 1.

Examples of neonatal pain assessment tools

Tool	Parameters	Score	Utility
Premature infant pain profile (PIPP) (24)	Gestational age, behavioral state, heart rate, oxygen saturation, brow bulge, eye squeeze, nasolabial furrow	Total: 0–21  each parameter scored 0–3; ≤6 minimal pain; >12 moderate to severe pain	Procedural and postoperative pain
FLACC (25)	Face, legs, activity, cry, consolability	Total: 0–10  each parameter scored 0–2; >4 moderate pain; >7 severe pain	Procedural and postoperative pain
COMFORT scale (behavioral and physiological parameters) (26)	Alertness, calmness, respiratory distress, movement, muscle tone, facial tension, blood pressure, heart rate	Total: 8–40  each parameter scored 1–5; 17–26 adequate sedation; ≥27 inadequate sedation/analgesia	Pain and sedation in NICU
COMFORT behavior scale (27)	Alertness, calmness, respiratory response (ventilated neonate) or crying (not ventilated), movement, muscle tone, facial expression	Total: 8–30  each parameter scored 1–5; >17 moderate pain requiring intervention	Postoperative pain in NICU