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Updated: Aug 6, 2026
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Modified Tail Vein and Penile Vein Puncture for Blood Sampling in the Rat Model
Published on: June 30, 2023
Venepuncture versus heel lance for blood sampling in term neonates
Gordon Martins1, Michelle Fiander2, Anna Taddio3
1Department of Paediatrics, Mount Sinai Hospital, Toronto, Canada.
The Cochrane Database of Systematic Reviews
|July 17, 2026
Summary
Venepuncture likely reduces pain and the need for repeat punctures compared to heel lance in neonates without sweet-tasting solutions. Further research is needed for cases involving analgesics.
Area of Science:
- Neonatal care
- Pain management in infants
- Evidence-based medicine
Background:
- Procedural pain is a significant concern in neonatal care.
- Routine blood sampling can cause considerable discomfort to neonates.
- This review compares venepuncture and heel lance for neonatal blood sampling.
Purpose of the Study:
- To evaluate the pain response and need for repeat punctures between venepuncture and heel lance in term neonates.
- To assess the benefits and harms of each blood sampling method.
- To inform clinical practice guidelines for neonatal pain management.
Main Methods:
- Systematic review and meta-analysis of randomized controlled trials (RCTs) and quasi-RCTs.
- Searched multiple databases (CENTRAL, MEDLINE, Embase) and trial registries up to July 2025.
- Included studies measuring pain via validated scores (e.g., Neonatal Facial Coding System) and number of skin punctures.
Main Results:
- Venepuncture likely reduces pain (SMD -1.34) and the need for more than one puncture (RR 0.63) compared to heel lance when no sweet-tasting solution is used (moderate-certainty evidence).
- When sweet-tasting solutions are used, venepuncture may reduce pain (SMD -0.38) but evidence on puncture numbers is very uncertain.
- Overall risk of bias in included studies was high, with concerns in blinding and allocation concealment.
Conclusions:
- Venepuncture is probably better than heel lance for reducing pain and repeat punctures in neonates when no sweet-tasting solution is administered.
- Evidence for the effectiveness of venepuncture with sweet-tasting solutions is limited and of low certainty.
- High-quality research is needed, especially in contexts using analgesics, to clarify comparative effectiveness.
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