Randomised controlled trial of paracetamol for heel prick pain in neonates
a Women's College Hospital, Department of
Newborn and Developmental Paediatrics, Faculty of Medicine,
University of Toronto, Ontario Canada M5S
1B2, b Department of
Paediatrics, The Hospital for Sick Children,
Toronto
Correspondence to: Dr Vibhuti Shah.
Accepted 14 June 1998
AIM
To evaluate the effectiveness of paracetamol
in decreasing the pain from heel prick.
METHODSA prospective randomised double blind
placebo controlled trial was conducted of 75 term neonates undergoing
heel prick. Sixty to 90 minutes before the procedure neonates received
paracetamol orally in a dose of 20 mg/kg (group 1) or an equal volume
of placebo (group 2). Heel prick was performed in a standardised
manner. Pain assessments were made using per cent facial action (brow bulge, eye squeeze, and nasolabial fold (range 0-300%) and per cent
of time spent crying (range 0-100%).
RESULTSThirty eight neonates were enrolled in
group 1 and 37 neonates in group 2. There were no significant
differences in the demographic characteristics between groups. Mean
gestational age was 39 (SD 1.4) vs 39.4 (SD 1.2) weeks,
p=0.86, mean birthweight 3.45 (SD 0.45) vs 3.44 (SD 0.42)
kg; p=0.31 for groups 1 and 2, respectively. Facial action pain scores
did not differ between groups (143.5 (SD 54.2)% vs 131.1 (SD 59.6)%; p=0.38). Cry scores also did not differ (29.4 (SD 19.9)%
vs 26.8 (SD 20.2)%; p=0.60). No adverse effects were observed.
CONCLUSIONParacetamol is ineffective for
decreasing the pain from heel prick in term neonates.
© 1998 by Archives of Disease in Childhood
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