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

ABSTRACT

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