Effect of automatic lancet and manual lancet for heel blood sampling on level of pain at term infants

Effect of Automatic Lancet and Manual Lancet for Heel Blood Sampling on Level of Pain at Term Infants Aim: The objective of this study is to evaluate the effect of automatic and manual lancet for heel blood sampling on pain level. Method: This research is a sectional, analytic and experimental study. Sixty healthy full-term neonates with a gestational age of 37 weeks or more were enrolled in this study. To randomize the subjects manual lancet was used at odd days and automatic lancet was used at even days for heel blood sampling. Lateral side of left heel was chosen for sampling at all infants. All heel blood sampling procedures were recorded by video camera. Heart rate and oxygen saturation were measured by pulse oximeter. To assess the pain level of infants, two expert nurses calculated NIPS scores (Neonatal Infant Pain Scale) by watching videos. Also puncture number, time to collect adequate blood volume, crying status, necessity of repeating procedure, complications that can occur after 4 hours from procedure(increased heat, swelling, redness, edema and bruise),blood bilirubin and hematocrit levels were evaluated. Wilcoxon test, Chi-square test, Mann-Whitney U test and T-test were used for analysis of data. Results: Post procedure mean oxygen saturation was significantly lower (P<0.001) and post procedure heart rate was significantly higher (P<0.05) in manual lancet group according to automatic lancet group. Rate of crying infants was lower at automatic lancet group (P<0.001). Number of punctures to obtain adequate blood volume were significantly higher at manual lancet group (P<0.001). Mean blood collection time was significantly shorter at automatic lancet group than manual lancet group (P<0.001). Among the post procedural complications there was no significant difference between two groups in swelling, edema and increased heat, but redness (P<0.05) and bruise (P<0.001) were lower at automatic lancet group. Mean of NIPS scores was significantly lower at automatic lancet group (P<0.001). While bilirubin levels did not show significant difference between two groups (P>0.05), hematocrit levels are lower at automatic lancet group (P<0.001). Conclusion: Our study demonstrated that automatic lancet use for heel blood sampling decreases pain level, complication rate, number of puncture, blood collection time and increases infant's comfort during the procedure. Keywords: infant; pain; lancet; heel blood sampling