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


OBJECTIVE
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.
Bonetto
Germán
G
Servicio de Pediatría, Sanatorio Allende, Córdoba, Argentina.
Salvatico
Estela
E
Varela
Natalia
N
Cometto
Cristina
C
Gómez
Patricia F
PF
Calvo
Bernardo
B
D000698:Analgesia / Q000379:methods*; D001800:Blood Specimen Collection / Q000009:adverse effects*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D010146:Pain / Q000209:etiology* / Q000517:prevention & control*; D011446:Prospective Studies; D047929:Term Birth