Blood sampling in infants (reducing pain and morbidity).
BACKGROUND
Preterm or ill neonates may undergo 1-21 heel punctures or venepunctures per day. These punctures are likely to be painful. Heel punctures comprise 61-87% and venepunctures comprise 8-13% of the invasive procedures performed on ill infants. Analgesics are rarely given specifically for blood sampling procedures, but 5-19% of infants receive analgesia for other indications.


METHODS
We conducted a systematic review and aimed to answer the following clinical question: What are the effects of interventions to reduce pain-related distress and morbidity during venepuncture in preterm or term babies aged under 12 months in a neonatal unit? We searched: Medline, Embase, The Cochrane Library, and other important databases up to July 2007 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA).


RESULTS
We found 16 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions.


CONCLUSIONS
In this systematic review we present information relating to the effectiveness and safety of the following interventions: oral sweet solutions, pacifiers, and topical anaesthetics (lidocaine-prilocaine cream, tetracaine).
Kapellou
Olga
O
Neonatal Unit, Chelsea and Westminster Hospital, London, UK.
D000284:Administration, Oral; D000700:Analgesics / Q000008:administration & dosage; D001800:Blood Specimen Collection; D004311:Double-Blind Method; D006801:Humans; D007223:Infant; D010146:Pain / Q000188:drug therapy; D010147:Pain Measurement; D018962:Phlebotomy; D011677:Punctures; D013748:Tetracaine / Q000627:therapeutic use
D000700:Analgesics; D013748:Tetracaine