Neonatal Pain Response to Various Heel Prick Devices: A Randomized Controlled Trial.

Abstract

BACKGROUND:

Heel prick is a commonly performed painful intervention in neonates. Though different devices are available, there is a need to compare the procedural pain response elicited by them.

OBJECTIVE:

To compare the neonatal pain response to three different heel prick devices; automatic lancet, manual lancet, and 26-gauge (G) hypodermic needle.

DESIGN:

Parallel-group three-arm randomized controlled trial.

PARTICIPANTS:

Clinically stable neonates of gestational age >28 weeks and birth weight >800 g undergoing heel prick for estimation of random blood sugar.

METHODS:

One hundred and eighty neonates were randomized to automatic lancet (n=59), manual lancet (n=59), or needle (n=62) groups between March, 2021 and August, 2022. The primary outcome was the premature infant pain profile-revised (PIPP-R) score. Secondary outcomes were post-intervention cerebral regional oxygen saturation (CrSO2), changes in CrSO2 (DCrSO2), the time for CrSO2 normalization using near-infrared spectroscopy, duration of audible cry, and the number of squeezes and pricks needed. Intention-to-treat analysis was done.

RESULTS:

Median (IQR) of PIPP-R scores were comparable in the automatic lancet [6 (4, 7.5)], manual lancet [5.5 (3.5, 8)], and needle [6 (3-9.6)] groups; P=0.59. No difference was observed in post-intervention CrSO2, DCrSO2, and the number of pricks. However, the time required for CrSO2 normalization and the number of squeezes were significantly higher with the needle.

CONCLUSION:

All three devices induced similar pain responses to heel prick in neonates; though, the number of squeezes needed was higher with the needle.

• Authors: Risha Devi, Mayank Priyadarshi, Poonam Singh, Suman Chaurasia, Sriparna Basu
• Journal: Indian pediatrics (Indian Pediatr) Vol. 60 Issue 11 Pg. 893-898 (Nov 15 2023) ISSN: 0974-7559 [Electronic] India
• PMID: 37551876 (Publication Type: Randomized Controlled Trial, Journal Article)

Topics

• Infant, Newborn
• Humans
• Infant
• Heel
• Pain Measurement (methods)
• Infant, Premature
• Pain (etiology)
• Pain Management (methods)