Table 1.

Most used Pain Scales in Infants and the NICU.

Scale	Use	Indicators Used	Scoring
PIPP [62]	Premature infants in NICU	3 behavioral (facial actions: brow bulge, eye squeeze, nasolabial furrow), 2 physiological (heart rate and oxygen saturation), and 2 contextual (GA and BS) items	Seven-item, four-point scale 21 points for preterm infants <28 weeks GA and 18 points for full-term infants
PIPP-R [63]	Extremely low gestational age (ELGA) infants	Same as PIPP	Seven-item, four-point scale
NIPS [64]	Infants < 1 year old	5 behavioral, (facial expression, cry, arms, legs, and state of arousal) 1 physiological factor (breathing patterns),	Score 0–7, Score > 3 is indicative of pain
NFCS [65]	premature neonates, term-born neonates, and infants ≤18 months of age	10 behavioral, (brow bulge, eye squeeze, nasolabial furrow, open lips, horizontal mouth stretch, vertical mouth stretch, taut tongue, lip purse, chin quiver, tongue protrusion.) Top 3 (brow bulge, eye squeeze, and nasolabial furrow) suffice for pain assessment.	Score 0–10 for premature infants: 10 Score 0–9 full term infants
COMFORTneo [67,68]	Premature infants in NICU	6 behavioral, (alertness, calmness, muscle tone, physical movement, facial tension, and respiratory behavior/crying). Respiratory behavior in ventilated patients and Crying in nonventilated patients.	6 items are scored on a 5-point scale, ranging from 1 to 5, with total score ranging from 6 to 30.
N-PASS [69]	NICU ventilated and/or postoperative infants 0–100 days of age, ≥ 23 weeks of gestation	3 behavioral, (behavior/state, facial expression, extremities/tone) 4 physiological vital signs (heart rate, respiratory rate, blood pressure and/or oxygen saturation)	Score 0–10

GA: Gestational age, BS: behavioral state, NICU: neonatal intensive care unit, PIPP: Premature Infant Pain Profile, PIPP-R: Premature Infant Pain Profile-Revised, NIPS: Neonatal Infant Pain Scale, NFCS: Neonatal Facial Coding System, N-PASS Neonatal Pain, Agitation, and Sedation Scale.