Pain reduction at venipuncture in newborn infants: oral glucose solution, EMLA cream(R) and pacifiers

Park, Sang Kee; Kim, Eun Young

Abstract

PURPOSE: We compared the pain reducing effect of orally administered glucose solution with EMLA cream and pacifiers during venipuncture in newborn infants.
METHODS
Fifty newborn infants(30 prematures) were enrolled in this study. We performed these four pain-reducing methods to all infants in serial order. Group A(control) did not receive any treatment; to group B, EMLA cream was applied on the skin for 1 hour; group C(or D) received 10 percent(or 30 percent) glucose solution orally; group E used pacifiers. Symptoms and signs associated with pain at venipuncture were measured with the Premature Infants Pain Profile(PIPP) scale.
RESULTS
There was no significant difference in the PIPP scores between preterm and fullterm infants. The mean PIPP scores of groups were A:12.5+/-2.5, B:10.1+/-2.6, C:9.4+/-2.0, D:6.5+/-2.1 and E:8.7+/-2.3; the mean scores of groups B, C, D and E were significantly lower than that of group A(all, P<0.001 except B(P<0.05)), and the mean score of D was significantly lower than those of B, C and E(P<0.001, P<0.005, P<0.05, respectively). The percentages of patients with PIPP scores above 6, which means pain, were A:100 percent, B:82 percent, C:56 percent, D:40 percent and E:70 percent. The percentages of patients with PIPP scores above 12, which means severe pain, were A:72 percent, B:30 percent, C:22 percent, D:0 percent and E:14 percent; that of group D was clearly lowest.
CONCLUSION
These results support the use of oral glucose solution, EMLA, and pacifiers for pain reduction as effective intervention at venipuncture in newborn infants. The most effective method was a 30 percent oral glucose solution.