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

ABSTRACT

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