Sammanfattning
Background: The aim of this study was to examine which method of PKU blood sampling is least painful for neonates.
Methods: A randomised controlled trial, comparing heel lancing and venepuncture using two different calibre needles at an obstetric unit in the south of Sweden. The trial included 90 healthy, full term, breast-fed neonates. An instrument for the measurement of neonatal pain, known as NIPS (Neonatal Infant Pain Scale) was used. The infants were randomised into three groups: venepuncture small (VPS — small calibre needle) n=30, venepuncture large (VPL — large calibre needle) n=30 and heel lancing (HL) n=30. All infants were observed for a minimum of 5 minutes during and after sampling. Statistical analysis included the median test (non-parametric) and chi2.
Results: Infants in the VPS group showed signs of significantly less pain than the heel lance group at 1 and 2 minutes during sampling. Failure to obtain the sample in 33% of the VPL group rendered the sample size too small for meaningful analysis. A subsidiary finding was that venepuncture was more difficult in higher birth weight infants.
Conclusions: If further studies confirm the results suggested here, that venepuncture using a small calibre needle is less painful for neonates, discussion should follow as to whether it is ethically justifiable to continue the practice of heel lancing.