Related Experiment Video
Updated: Jun 27, 2026
A Preterm Rat Model for Pain Studies
Published on: February 9, 2024
[Pain prevention in term neonates: randomized trial for three methods]
Germán Bonetto1, Estela Salvatico, Natalia Varela
1Servicio de Pediatría, Sanatorio Allende, Córdoba, Argentina.
Insights
Oral glucose effectively reduced pain in newborns during heel prick blood tests, unlike paracetamol or EMLA. Further research into combined methods is recommended to minimize infant pain.
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.
Introduction:
Every newborn infant is screened for hypothyroidism and phenylketonuria by blood sampling, during the first week of life, but there is not a simple and efficient method to reduce pain during the procedure.
Objectives:
Prospective randomised trial, to assess if the administration of oral glucose, paracetamol or EMLA, given individually, can reduce the pain caused in newborns by heel prick, in an outpatient setting.
Methods:
Double-blind study in which seventy six healthy newborns at term were randomly assigned to receive placebo, oral glucose, EMLA in the heel, or oral paracetamol. Heel prick was performed to get a blood sample, and pain was measured by two independent observers, using two scales (NIPS and PIPP).
Results:
NIPS <4: placebo (9/19= 47%), glucose (16/19= 84%), paracetamol (8/19= 42%) and EMLA (12/19= 63%); PIPP <8: placebo (9/19= 47%), oral glucose (12/19= 63%), paracetamol (5/19= 26%) and EMLA (8/19= 42%). With the use of oral glucose we found RAR: 0.37 (IC 95% 0.09-0.64), RRR: 44% (IC 95% 6-67%), NNT: 2.7 (IC 95% 1.5-11).
Conclusions:
The best results were obtained with the use of oral glucose, being statistically significant with only one of the scales. The administration of paracetamol or EMLA did not reduce pain. Other complementary and/or combined methods, added to oral glucose, should be considered daily to diminish this painful experience in thousands of children.
