Fetal pain: a systematic multidisciplinary review of the evidence.

@article{Lee2005FetalPA,
  title={Fetal pain: a systematic multidisciplinary review of the evidence.},
  author={Susan J. Lee and H. J. Ralston and Eleanor A. Drey and John Colin Partridge and Mark A. Rosen},
  journal={JAMA},
  year={2005},
  volume={294 8},
  pages={
          947-54
        }
}
CONTEXT Proposed federal legislation would require physicians to inform women seeking abortions at 20 or more weeks after fertilization that the fetus feels pain and to offer anesthesia administered directly to the fetus. This article examines whether a fetus feels pain and if so, whether safe and effective techniques exist for providing direct fetal anesthesia or analgesia in the context of therapeutic procedures or abortion. EVIDENCE ACQUISITION Systematic search of PubMed for English… 
Compassionate Treatment of Fetal Pain
TLDR
It is the duty of the profession to adopt a compassionate attitude to alleviate pain and suffering of the unborn child, starting at 18-20 weeks' gestation, as the authors do for their neonates.
Can fetus feel pain in the second trimester? Lessons learned from a sentinel event
TLDR
The fetal stress response to noxious stimulation that the authors observed in this case does not prove that the fetus has a conscious perception of pain, but it is very unlikely that there may be pain perception without a stress response, as it is often used as a surrogate indicator for pain.
The Problem of Fetal Pain and Abortion: Toward an Ethical Consensus for Appropriate Behavior
  • E. Brugger
  • Medicine
    Kennedy Institute of Ethics journal
  • 2012
TLDR
It is proposed that where abortion is legal, providers should be legally required both to provide full disclosure of the possibility of fetal pain starting at 20 weeks and to offer pain-relief measures to suppress fetal pain to all women seeking an abortion.
Fetal Pain in the First Trimester
TLDR
Current neuroscientific evidence indicates the possibility of fetal pain perception during the first trimester (<14 weeks gestation), and the use of fetal analgesia suppresses the hormonal, physiologic, and behavioral responses to pain.
[Fetal pain and intrauterine analgesia/anesthesia: neuroanatomy, ontogenesis and physiology of pain perception].
TLDR
The definition of pain and the neuroanatomical structures participating in subjective pain perception, followed by the development of the latter in the course of ontogeny is presented and the objective indicators of intrauterine stress response evoked by noxious stimuli are discussed.
Opposition to abortion related to inaccurate beliefs about fetal pain perception in utero.
TLDR
Most participants believed that a fetus develops the capacity to perceive pain earlier than developmental reality, and this belief correlates with anti-choice views.
Fetal Pain: The Science Behind Why It Is the Medical Standard of Care
TLDR
An overview of relevant publications is provided that explain the clinical evolution that has led to the treatment of neonatal pain and three arguments against the existence of fetal pain are examined.
Fetal and Maternal Analgesia/Anesthesia for Fetal Procedures
TLDR
The extent to which a fetus is influenced by the maternal anesthesia depends on the type of anesthesia, with different needs for extra fetal anesthesia or analgesia.
Fetal and maternal analgesia/anesthesia for fetal procedures.
TLDR
The extent to which a fetus is influenced by the maternal anesthesia depends on the type of anesthesia, with different needs for extra fetal anesthesia or analgesia.
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References

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TLDR
The body of scientific evidence regarding the mechanisms and effects of nociceptive activity in newborn infants has not been addressed directly and the pervasive view of neonatal pain is that newborns are frequently not given analgesic or anesthetic agents during invasive procedures, including surgery.
Locating the beginnings of pain.
TLDR
The major moral implication of this stance is to place the burden of proof for analgesic use onto clinical measures, rather than relying upon the, so far, poorly supported assumption of pain awareness.
Procedural Pain in Newborn Infants: The Influence of Intensity and Development
TLDR
Similar to what has been shown in adults, newborn and developing infants show increased magnitude physiologic and behavioral responses to increasingly invasive procedures, demonstrating that even very prematurely born infants respond to pain and differentiate stimulus intensity.
Effect of Direct Fetal Opioid Analgesia on Fetal Hormonal and Hemodynamic Stress Response to Intrauterine Needling
TLDR
It is concluded that intravenous fentanyl attenuates the fetal stress response to intrahepatic vein needling in alloimmunized fetuses undergoing intravascular transfusion between 20 and 35 weeks.
A Pain in the Fetus: Toward Ending Confusion About Fetal Pain
TLDR
The problem of determining when, in its development, a human becomes capable of feeling pain is elucidated and the available data are examined showing how, on balance, it tends more to support than undermine the claim that fetuses of around 28 to 30 weeks' gestation are capable of Feeling pain.
Remifentanil for Fetal Immobilization and Maternal Sedation During Fetoscopic Surgery: A Randomized, Double-Blind Comparison with Diazepam
TLDR
It is concluded that remifentanil produces improved fetal immobilization with good maternal sedation and only minimal effects on maternal respiration.
Fetal pain: implications for research and practice
TLDR
To address the question of pain in the fetus, one must use indirect evidence from a variety of sources, and then make an informed guess, similar to that which is used with animals with animals.
Fetal Pain: An Infantile Debate
TLDR
In their vituperative response, Benatar and Benatar bite off my finger before looking to where I am pointing, and the author will examine each of their criticisms.
Pain and stress in the human fetus.
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