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Pain reduction at venipuncture in newborn infants : oral glucose solution, EMLA cream and pacifiers

Korean Journal of Pediatrics 2006;49(4):388-393.
Published online April 15, 2006.
Pain reduction at venipuncture in newborn infants : oral glucose solution, EMLA cream and pacifiers
Sang Kee Park, Eun Young Kim
Department of Pediatrics, College of Medicine, Chosun University, Gwangju, Korea
신생아의 정맥천자시 통증 감소 효과 : 경구 포도당액, EMLA 크림 및 노리개 젖꼭지
박상기, 김은영
조선대학교 의과대학 소아과학교실
Correspondence: 
Sang Kee Park, Email: skpark@chsun.ac.kr
Abstract
Purpose
: We compared the pain reducing effect of orally administered glucose solution with EMLA cream and pacifiers during venipuncture in newborn infants.
Methods
: Fifty newborn infants(30 prematures) were enrolled in this study. We performed these four pain-reducing methods to all infants in serial order. Group A(control) did not receive any treatment; to group B, EMLA cream was applied on the skin for 1 hour; group C(or D) received 10 percent(or 30 percent) glucose solution orally; group E used pacifiers. Symptoms and signs associated with pain at venipuncture were measured with the Premature Infants Pain Profile(PIPP) scale.
Results
: There was no significant difference in the PIPP scores between preterm and fullterm infants. The mean PIPP scores of groups were A : 12.5¡¾2.5, B : 10.1¡¾2.6, C : 9.4¡¾2.0, D : 6.5¡¾2.1 and E : 8.7¡¾2.3; the mean scores of groups B, C, D and E were significantly lower than that of group A(all, P<0.001 except B(P<0.05)), and the mean score of D was significantly lower than those of B, C and E(P<0.001, P<0.005, P<0.05, respectively). The percentages of patients with PIPP scores above 6, which means pain, were A : 100 percent, B : 82 percent, C : 56 percent, D : 40 percent and E : 70 percent. The percentages of patients with PIPP scores above 12, which means severe pain, were A : 72 percent, B : 30 percent, C : 22 percent, D : 0 percent and E : 14 percent; that of group D was clearly lowest.
Conclusion
: These results support the use of oral glucose solution, EMLA, and pacifiers for pain reduction as effective intervention at venipuncture in newborn infants. The most effective method was a 30 percent oral glucose solution.
Key Words: Pain , Glucose , EMLA cream , Pacifiers , Newborn


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