Blood sampling in infants (reducing pain and morbidity).

ABSTRACT

INTRODUCTION: Preterm or ill neonates may undergo 1 to 21 heel punctures or venepunctures a day. These punctures are likely to be painful. Heel punctures comprise 61% to 87% and venepunctures comprise 8% to 13% of the invasive procedures performed on ill infants. Analgesics are rarely given specifically for blood sampling procedures, but 5% to 19% of infants receive analgesia for other indications. METHODS AND OUTCOMES: We conducted a systematic review and aimed to answer the following clinical question What are the effects of interventions to reduce pain-related distress and morbidity during venepuncture in preterm or term babies aged under 12 months in a neonatal unit? We searched Medline, Embase, The Cochrane Library, and other important databases up to June 2010 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). RESULTS: We found 20 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. CONCLUSIONS: In this systematic review we present information relating to the effectiveness and safety of the following interventions: oral sweet solutions; pacifiers; and topical anaesthetics (lidocaine-prilocaine cream, tetracaine).