Pain reducing in icteric neewborns while venipuncturing: comparison of local anesthetic cream with orally glucose

A number of studies has shown that orally administered sweet-tasting solutions reduce signs of pain during painful procedures. The local anesthetic cream EMLA has recently been shown to be safe for use in neonates. The present study aimed to compare the pain-reducing effect of EMLA cream with that of orally administered glucose during venipuncturing in newborns in Yazd city. A randomized, controlled, double-blind Clinical trial was done on the 220 newborns undergoing venipuncture for clinical purposes. One hundred- six of the newborns received EMLA on the skin and orally administered placebo [sterile water] and 114 received orally glucose 30% and placebo [Vit A+D] on the skin. Symptoms associated with pain while venipuncturing measured by Neonatal/ Infant pain scale [NIPS] and crying time were compared between two groups. There were no differences in background variables between the 2 groups. The results showed that the NIPS scores were significantly lower in the glucose group [Median: 2] compared with the EMLA group [Median: 3] [P=.000]. The duration of crying in the first 2 minutes was significantly lower in the glucose group [Median: 2sec] than in EMLA group [Median: 9sec] [P<.01]. 12.3% and 29.2% of neonates in glucose and EMLA groups had NIPS above 3 respectively where the observed difference was found to be statistically significant [P<.05]. Our study showed that compared with EMLA cream, orally administration glucose can be more effective, tolerable and convenient in reducing of pain resulting from venipuncturing in neonatal period

[Comparison of the effectiveness of oral sucrose and EMLA cream in reduction of a cute pain due to heel sticks for blood sampling in neonates]

Certain painful, invasive procedures are necessary for care, and are commonly performed in both healthy and sick neonates. Current evidence shows that the newborn infant has both physiologic and anatomic capacity to experience pain. Recent research suggests that pain experienced in the neonatal period might have long-term effects later in life. Previous research has shown that orally administered sweet-tasting solutions reduce signs of pain during painful procedures. This effect is considered to be mediated both by the release of endorphins and by a preabsorptive mechanism related to the sweet taste. This study was a controlled, randomized and double-- blind study on 210 neonates. These newborns were randomly divided into 3 groups; A, Band C. Group A received 2 nil of 25% sucrose orally as well as base cream was applied at the site for heel stick, group B received 2 ml of distilled water and application of EMLA cream, while group C received 2 ml of distilled water and base cream. The heart rates of the newborn were recorded by the cardiac monitor before and after heel stick blood sampling and the duration of crying was determined as well. Pain was scored by DAN scale. There were no differences in demographic characteristics of all neonates. The results showed that the DAN scale was significantly lower in the sucrose group [mean: 3.840] as compared to the EMLA group [mean: 3.366] and the placebo group[5.557], but the difference in the duration of crying was not significantly different in the sucrose group [mean: 10.5 second] and the EMLA group[n can 8.76]. Both sucrose and EMLA are effective in reducing stress associated with heel lancet in newborns, but as sucrose acts faster and is healthier, its usage is proposed in neonates requiring heel sticks for blood sampling

Comparison of the effect of local anesthetic cream and orally administered glucose solution in reduction of pain in icteric newborns during venipuncture

A number of studies have shown that orally administered sweet-tasting solutions reduce feeling of pain during invasive procedures. The local anesthetic cream EMLA has recently been shown to be safe for use in neonates. The present study aimed to compare the pain-reducing effect of EMLA cream with that of orally administered glucose during venipuncturing of newborns in Yazd city. A randomized, controlled, double blind clinical trial was performed on 220 newborns undergoing venipuncture for clinical reasons. EMLA cream was applied to the skin of 106 of the newborns, along with orally administered sterile water as placebo. In addition, a 30% solution of glucose was administered orally to 114 neonates whose skin was treated with vitamin A+D cream as placebo. Symptoms associated with pain while venipuncturing measured by Neonatal/ Infant pain scale [NIPS] and crying time was compared between the two groups. There were no differences in background variables between the 2 groups. The results showed that the NIPS scores were significantly lower in the glucose group [Median: 2] compared with the EMLA group [median: 3] [p<0.001]. The duration of crying in the first 2 minutes was significantly lower [p<0.01] in the glucose group [median: 2 sec] than in EMLA group [median: 9 sec]. The NIP values higher than 3 were observed in 12.3% and 29.2% of neonates in glucose and EMLA groups respectively, where the difference was found to be statistically significant [p<0.05]. Our study showed that compared with EMLA cream, orally administered glucose can be more effective, tolerable and convenient in reducing pain from venipuncturing in neonates

[ effect of zinc supplementation on treatment of acute watery diarrhea in 1-4 year old children]

Patients with diarrhea are susceptible to zinc deficiency. Zinc deficiency can cause growth retardation, delay in sexual maturity, behavior disorders, persistent diarrhea and abnormalities of immune system, susceptibility to respiratory and gastrointestinal infections and impairment of taste and smell perception. The aim of this study was to evaluate of the effect of oral zinc supplementation on the treatment of acute watery diarrhea.This study was a randomized double-blind placebo controlled clinical trial that was carried out in 139 children, aged 1 to 4 years, with acute watery diarrhea referred to two out-patient pediatric clinics in Yazd. Participants were randomly divided into two groups, zinc group [ZG] and placebo group [PG]. The former group received zinc sulphate 2 mg/kg qd orally for 10 days and the latter group were treated with saline-dextrose solution [1/3:2/3]. Duration and frequency of the diarrhea episodes were recorded in each group. Data were analyzed using Chi-square and Student t-test. The mean frequency of diarrhea at the first visit in ZG and PG groups were 4.6 +/- 1.7 and 4.2 +/- 1.5, respectively [p=0.1]. At forty-eight to 72 h post-intervention, these values were 2.32 +/- 1.43 and 3.84 +/- 1.34 for girls [p=0.001], and 2.21 +/- 1.49 and 3.9 +/- 1.8 [p=0.001], for boys respectively. In general, after five days intervention, 45 patients [43%] were recovered, that 24 [53%] of them were from ZG. However, 10 days after the intervention the recovery rate in the ZG was markedly higher than the control group. At the end of the intervention, 80 [77%] patients, with 50 cases [66%] belonging to the ZG completely recovered. This study showed that oral zinc supplementation [2mg/kg qd] in children with acute watery diarrhea reduces the duration and severity of diarrhea

[Comparison of topical EMLA cream with oral glucose on pain reduction at venipuncture in ichteric newborns]

A number of studies have shown that orally administered sweet-tasting solutions reduce signs of pain during painful procedures. The topical anesthetic cream EMLA has recently been shown to be safe for use in neonates. This study compared the pain-reducing effect of EMLA cream with that of orally administered glucose during venipuncture in newborns. A randomized controlled, double-blind study including 220 newborns undergoing venipuncture for clinical purposes was performed. One hundered and six newborns received EMLA on the skin and orally administered placebo [sterilized] and 114 received glucos- 30% orally and placebo [Vit A+D] on the skin. Symptoms associated with pain at venipuncture were measured with the Neonatal/ Infant Pain Scale [NIPS]. Crying time was recorded. The results showed that the NIPS scores were significantly lower in the glucose group [mean: 1.89] compared to the EMLA group [mean: 2.81]. The duration of crying in the first 2 minutes was significantly lower in the glucose group [median=2 seconds] than in the EMLA group [median=9 seconds]. There were significantly fewer patients in the glucose group who were scored having pain [defind as NIPS scores above 3], 12.3% compared with 29.2% in the EMLA group. We found that glucose is effective in reducing symptoms associated with pain from venipuncture in newborns. Our results showed that glucose is more effective than the local anesthetic cream EMLA