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Venepuncture versus heel lance for blood sampling in term neonates
1Associate Professor, Departments of Paediatrics and Health Policy, Management and Evaluation, University of Toronto, 600 University Avenue, Toronto, Ontario, Canada, M5G 1X5.
The Cochrane Database of Systematic Reviews
|October 7, 2011
Summary
Venepuncture is less painful and more effective than heel lance for neonatal blood sampling. Using a sweet tasting solution further reduces pain, making venepuncture the preferred method for skilled phlebotomists.
Area of Science:
- Neonatal care
- Pediatric phlebotomy
- Pain management in infants
Background:
- Heel lance is the standard for neonatal blood sampling, but causes significant pain.
- Current pain alleviation methods for heel lance are insufficient.
Purpose of the Study:
- To compare the pain and effectiveness of venepuncture versus heel lance for blood sampling in term neonates.
- To evaluate the impact of sweet tasting solutions on pain during these procedures.
Main Methods:
- Systematic review and meta-analysis of randomized or quasi-randomized controlled trials.
- Searched multiple databases (Cochrane, MEDLINE, EMBASE, CINAHL) and clinical trial registries.
- Analyzed pain scores, repeat sampling rates, and cry characteristics.
Main Results:
- Venepuncture significantly reduced pain scores compared to heel lance (SMD -0.76).
- Sweet tasting solutions further decreased pain with venepuncture (SMD -0.38).
- Venepuncture reduced the need for repeat punctures (NNT=3).
Conclusions:
- Venepuncture by skilled phlebotomists is the preferred method for neonatal blood sampling.
- Sweet tasting solutions enhance pain reduction during venepuncture.
- Further research is needed in diverse clinical settings.
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