Comparison of Pain Response to Heel Prick and Venepuncture in Term Babies

Objective: The objective of the study was to know the difference in the behavioural pattern that appear with painful stimuli in term neonates and also to compare the pain response to venepuncture&heel prick for blood sampling in term neonates.

Method: 70 healthy term neonates between 37 weeks to 42 weeks of gestational age, who required blood sampling for bilirubin or blood sugar estimation within the first week of life, were selected for the study. Selected cases were equally divided into 2 groups. In group 1, blood sampling was done by venepuncture and in group 2, blood sampling was done by heel prick. The state of arousal in neonates was assessed before the procedure with prechtl and beintema score. The pain following the procedure was measured in terms of behavioural pain score. Oxygen saturation, heart rate and respiratory rate were monitored by a single observer. The data collected was statistically analyzed by using Fisher's 'Z' test.

Results: 1. The behavioural pain response scores were increased in both the groups. 2. In response to painful stimuli, there was increase in heart rate and respiratory rate and decrease in oxygen saturation in both the groups. 3. The study revealed that term neonates who underwent heel prick had higher pain score than venepuncture 4. There was no difference in pain response score between male and female babies in both the groups.

Conclusion: Pain response was more during heal prick than venepuncture. Like adults, babies do experience pain. Hence it is necessary to use analgesia during any painful procedures.