[Pain prevention in term neonates: randomized trial for three methods].

Area of Science:

• Neonatal care
• Pain management
• Pediatric research

Background:

• Newborns undergo routine blood sampling for conditions like hypothyroidism and phenylketonuria.
• Current methods for pain reduction during heel pricks are limited.
• Effective pain management strategies are crucial for infant well-being.

Purpose of the Study:

• To evaluate the efficacy of oral glucose, paracetamol, and EMLA in reducing pain during newborn heel pricks.
• To compare these interventions against a placebo in a randomized trial.
• To identify simple and efficient methods for pain reduction in neonates.

Main Methods:

• A prospective, double-blind, randomized trial involving 76 healthy, full-term newborns.
• Participants were assigned to receive placebo, oral glucose, EMLA, or oral paracetamol.
• Pain was assessed by two independent observers using the Neonatal Infant Pain Scale (NIPS) and Premature Infant Pain Profile (PIPP).

Main Results:

• Oral glucose showed a statistically significant reduction in pain scores on one scale (PIPP).
• Pain reduction rates for NIPS were: placebo (47%), glucose (84%), paracetamol (42%), EMLA (63%).
• Pain reduction rates for PIPP were: placebo (47%), glucose (63%), paracetamol (26%), EMLA (42%).

Conclusions:

• Oral glucose demonstrated the most promising results in alleviating pain during heel prick procedures.
• Paracetamol and EMLA did not significantly reduce pain compared to placebo.
• Combined or complementary methods with oral glucose may offer further benefits for managing procedural pain in newborns.