ALLEVIATION OF THE PAIN OF VENIPUNCTURE IN NEONATES

A recent study has shown venepuncture to be more effective and less pa inful than heel-lancing when a single blood test is performed in neona tes [Larsson, Pediatrics (in press)]. The aim of the present study was to investigate the value of EMLA applied on the dorsum of the hand wh en sampling blood in neonates. Methods: This was a controlled randomiz ed and double-blinded study. One hundred and twenty neonates were rand omly allocated to two groups, EMLA or placebo. Five hundred milligrams (0.5 ml) of EMLA or placebo was placed on the dorsum of the hand, cov ered with an occlusive dressing, and left in place for 60 minutes. For venepuncture, a needle measuring 0.9 x 40 mm was used. The two groups were also compared as regards the total time needed to complete the P KU test and the number of skin punctures required. The facial reaction was videotaped and later analysed by two blinded observers using the Neonatal Facial Coding System (NFCS). Results: No side effects occurre d, except for a temporary blanching or redness of the skin, which disa ppeared within minutes. Nociceptive response: After skin puncture, the NFCS scores were significantly lower in the EMLA group than in the pl acebo group (median 287 and 374, respectively). After the first skin p uncture, a cry was recorded in 35/55 cases (64%) in the EMLA group and in 38/56 cases (68%) in the placebo group, this difference was not si gnificant. The duration of the first cry was significantly shorter in the EMLA than in the placebo group (median 12 and 31 s, respectively). Conclusion: In comparison with a placebo, EMLA significantly reduces the pain caused by venepuncture on the dorsum of the hand and does not complicate puncture of the vein.