[The effect of two different methods of heel lancing on pain reaction in preterm neonates]

Heel lancing is the most used method to obtain a blood sample in newborn and pre-term infants. The effectiveness on pain reduction of a new lancet, Tenderfoot was compared against the traditional Lancetta, randomizing 40 preterm newborns to have the heel lanced with one of the two instruments and observing overall 76 blood sampling episodes. Newborns were observed at baseline, when disinfected, during and at the end of the blood sampling procedure. Statistically different behavioural responses to the pain of the puncture were observed during the blood sampling, in the 'recovery time' after the procedure and in the number of pricks performed. When the Tenderfoot was used, less children cried during the first 5 seconds after the prick. The Tenderfoot is effective in reducing the heel prick pain, allows an easier collection of the blood, a reduction of the time necessary and of the need of squeezing the heel, therefore reducing the bruises and pain related to the squeezing itself. According to our data, its use is recommended for the obtainment of large quantities of blood, and in the severely ill newborns, that need frequent blood monitoring and several pricks. These characteristics render its use debatable because of the costs and of the bleeding for blood exams that require limited amount of blood (blood glucose, blood gas analysis) until its effects on the scarring time and outcome will be documented.