Document Detail

Alleviation of the pain of heel prick in preterm infants.
MedLine Citation:
PMID:  8198410     Owner:  NLM     Status:  MEDLINE    
The hypothesis that the variability of physiological parameters may indicate pain or stress in the neonate was examined. Four parameters (heart rate, respiratory rate, transcutaneous oxygen tension, and carbon dioxide tension) were examined over a 2 minute epoch in response to a heel prick in an attempt to measure stress/pain in 35 preterm newborn infants (26-34 weeks' gestation) half of whom were receiving intensive care. The change in absolute values of these parameters did not discriminate a dummy procedure without prick from the actual procedure containing the prick (paired t test), but the variability of the parameters during an epoch showed significant discrimination. Three procedures were evaluated to reduce this distress using unpaired t test. The use of local anaesthetic cream was not successful. The components of the mixture cause vasoconstriction that would reduce blood flow to the heel and lead to more squeezing which is likely to be painful in the presence of tissue damage. A nurse comforting the infant with tactile and vocal stimulation was slightly helpful but the use of a spring loaded lance was most successful in reducing the distress. The use of spring loaded lances may be more humane for heel pricks.
N McIntosh; L van Veen; H Brameyer
Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Archives of disease in childhood. Fetal and neonatal edition     Volume:  70     ISSN:  1359-2998     ISO Abbreviation:  Arch. Dis. Child. Fetal Neonatal Ed.     Publication Date:  1994 May 
Date Detail:
Created Date:  1994-06-29     Completed Date:  1994-06-29     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  9501297     Medline TA:  Arch Dis Child Fetal Neonatal Ed     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  F177-81     Citation Subset:  IM    
Department of Child Life and Health, University of Edinburgh.
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MeSH Terms
Anesthetics, Local
Blood Gas Monitoring, Transcutaneous
Blood Specimen Collection / adverse effects*,  instrumentation,  nursing
Carbon Dioxide / blood
Drug Combinations
Heart Rate / physiology
Infant, Newborn
Infant, Premature* / physiology
Pain / nursing,  prevention & control*
Respiration / physiology
Reg. No./Substance:
0/Anesthetics, Local; 0/Drug Combinations; 0/EMLA; 0/Ointments; 124-38-9/Carbon Dioxide; 137-58-6/Lidocaine; 721-50-6/Prilocaine

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