The Effects of Manual and Automatic Lancets on Neonatal Capillary Heel Blood Sampling Pain: A Prospective Randomized Controlled Trial

Abstract

Purpose: The aim of this study was to determine the effects of manual lancets and automatic lancets on neonatal capillary heel blood sampling pain. Design and methods: This was a parallel-group, prospective, randomized controlled and observational trial. Participants were randomly assigned (1:1) to the manual lancet (odd days of the month) and automatic lancet groups (even days of the month) for capillary heel blood sampling. The sample consisted of 60 term neonates divided into two groups: Manual lancet (n=30) and automatic lancet (n=30). Heart rate, oxygen saturation, duration of blood collection, presence of crying, number of heel punctures, possible complications and pain were measured. Results: The manual lancet group had significantly lower oxygen saturation (P=.000), higher mean heart rate (P=.008), more crying neonates (P=.000), higher number of punctures for blood sampling (P=.000) and longer mean duration of blood collection (P=.000) than the automatic lancet group. While there was no difference in the prevalence of elevated temperature, stiffness and edema between the two groups, the automatic lancet group had less redness (P=.028), bruising (P=.000) and a significantly lower mean Neonatal Infant Pain Score than the manual lancet group (P=.000). Conclusion: Use of automatic lancets for heel blood sampling helps reduce pain in neonates which is of critical importance. Practice implications: Use of automatic lancets for heel blood sampling helps reduce pain in neonates. Therefore, neonatal nurses should routinely use automatic lancets in clinical settings to cause less pain in neonates. (C) 2020 Elsevier Inc. All rights reserved.