Stress and pain relief in the care of the surgical neonate

In recent years, there has been a major change in our thinking about the way neonates experience stress. This understanding has led to advances in anesthetic technique and the pre- and postoperative care of the surgical neonate. Stress can develop before birth due to placental insufficiency. This can lead to preterm delivery, and the preterm infant is much more vulnerable to stressful stimulus. Stress is detrimental to the neonate in the short term and can also have adverse effects on the future wellbeing of the child. Limiting stress is not just about good pain control. The nursing environment is vitally important. Much can be achieved with good attention to detail in this respect. The effects of stress and the ways they can be minimized are discussed.