Can nitroglycerine ointment facilitate newborn heelstick blood collection? A randomized controlled trial.
Newborn heelstick blood collection can be a painful procedure in part because of the time required to obtain sufficient quantity of blood. No previous studies have determined whether local vasodilatation using topical nitroglycerine ointment (NGO) would facilitate heelstick blood collection.


OBJECTIVE
To determine if the topical application of NGO would reduce the time needed to collect the required amount of blood for newborn metabolic screening and, in turn, reduce the pain/distress of the procedure.


METHODS
In a randomized, prospective, placebo controlled and blinded fashion, term newborns in a well nursery received either topical nitroglycerine or placebo ointment 10 minutes prior to heelstick. Total time and number of heelsticks required to complete the collection were measured along with crying time, heart rate and blood pressure.


RESULTS
In all, 50 were studied, 25 in each group. There was no statistical difference between groups in collection time, crying time or number of heelsticks required for completion. Heart rate increased significantly and equally in both groups. Blood pressures were unchanged.


CONCLUSIONS
Topical NGO did not facilitate heelstick blood collection or reduce the pain/distress of the procedure.
Cecchi
Laura M
LM
Trinity College, Connecticut Children's Medical Center Hartford, CT 06106, USA.
Lerer
Trudy
T
Herson
Victor C
VC
D000287:Administration, Topical; D001794:Blood Pressure / Q000187:drug effects; D001800:Blood Specimen Collection / Q000009:adverse effects*; D003448:Crying; D004311:Double-Blind Method; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D016602:Needlestick Injuries / Q000150:complications*; D005996:Nitroglycerin / Q000008:administration & dosage* / Q000627:therapeutic use*; D009824:Ointments; D010146:Pain / Q000209:etiology* / Q000517:prevention & control*; D013997:Time Factors; D014665:Vasodilator Agents / Q000008:administration & dosage* / Q000627:therapeutic use*
D009824:Ointments; D014665:Vasodilator Agents; D005996:Nitroglycerin