{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T01:59:57Z","timestamp":1791251997335,"version":"4.1.0"},"reference-count":21,"publisher":"American Academy of Pediatrics (AAP)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[1998,5,1]]},"abstract":"<jats:p>Objective.\u2003Heel lancing has hitherto been the method of choice for screening tests of inborn errors of metabolism in neonates. Eutectic mixture of local anesthetic has little, if any, analgesic effect when applied to the heel of pre- and full-term infants. Today there seems to be no practical method that effectively alleviates the pain caused by heel lancing. The aim of this study was to investigate whether other methods, such as venipuncture of the dorsal side of the hand, are less painful and more efficient than heel lancing in neonates.<\/jats:p><jats:p>Methods.\u2003One hundred twenty healthy, full-term infants who underwent testing for phenylketonuria (PKU) were included in the study. They were randomized into three groups: a venipuncture group (VP) (n = 50), a heel-lance group with a small lancet (SL) (n = 50), or a large lancet (LL) (n = 20). Pain reactions were assessed by the Neonatal Facial Coding System (NFCS). The latency and duration of the first cry as well as the total screaming time was analyzed. The efficacy of the method was assessed by the time taken to complete the PKU test and number of times the skin had to be punctured.<\/jats:p><jats:p>Results.\u2003Nociceptive response. The NFCS scores after the first skin puncture were: VP, 247; SL, 333; and LL, 460. The NFCS scores were significantly lower in the VP than in the groups subjected to heel lancing. During the first 60 seconds after skin puncture, 44% of the infants cried in the VP group, compared with 72% and 85% in the SL and LL groups, respectively.<\/jats:p><jats:p>Efficacy.\u2003A successful PKU test with only one skin puncture was performed in 86% of the VP group, but in only 19% in the SL group and 40% in the LL group. The total time needed to obtain the PKU blood sample was 191 seconds (median) in the VP group, 419 seconds in the SL group, and 279 seconds in the LL group.<\/jats:p><jats:p>Conclusion.\u2003Venipuncture is more effective and less painful than heel lancing for blood tests in neonates.<\/jats:p>","DOI":"10.1542\/peds.101.5.882","type":"journal-article","created":{"date-parts":[[2004,8,13]],"date-time":"2004-08-13T23:44:32Z","timestamp":1092440672000},"page":"882-886","source":"Crossref","is-referenced-by-count":95,"title":["Venipuncture Is More Effective and Less Painful Than Heel Lancing for Blood Tests in Neonates"],"prefix":"10.1542","volume":"101","author":[{"given":"Bjo\u0308rn A.","family":"Larsson","sequence":"first","affiliation":[{"name":"From the Department of Pediatric Anesthesia and Intensive Care, Pain Treatment Service; and the"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gunnilla","family":"Tannfeldt","sequence":"additional","affiliation":[{"name":"From the Department of Pediatric Anesthesia and Intensive Care, Pain Treatment Service; and the"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hugo","family":"Lagercrantz","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Karolinska Hospital, Karolinska Institute, Stockholm, Sweden."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gunnar L.","family":"Olsson","sequence":"additional","affiliation":[{"name":"From the Department of Pediatric Anesthesia and Intensive Care, Pain Treatment Service; and the"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[1998,5,1]]},"reference":[{"key":"2021121010115181700_B1","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1016\/0304-3959(84)90813-3","article-title":"Pain in infancy: neonatal reaction to a heel lance.","volume":"20","author":"Owens","year":"1984","journal-title":"Pain"},{"key":"2021121010115181700_B2","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1016\/0304-3959(93)90116-7","article-title":"The pain of heel prick and its measurement in preterm infants.","volume":"52","author":"McIntosh","year":"1993","journal-title":"Pain"},{"key":"2021121010115181700_B3","doi-asserted-by":"crossref","first-page":"1028","DOI":"10.1111\/j.1399-6576.1995.tb04223.x","article-title":"Does a local anaesthetic cream (EMLA) alleviate pain from heel lancing in neonates?","volume":"23","author":"Larsson","year":"1995","journal-title":"Acta Anaesth"},{"key":"2021121010115181700_B4"},{"key":"2021121010115181700_B5","doi-asserted-by":"crossref","first-page":"791","DOI":"10.1111\/j.1651-2227.1993.tb12560.x","article-title":"Analgesic effect of lidocaine ointment on intact skin in neonates.","volume":"82","author":"Wester","year":"1993","journal-title":"Acta Paediatr"},{"key":"2021121010115181700_B6","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1111\/j.1460-9592.1996.tb00370.x","article-title":"Regional variations in skin perfusion and skin thickness may contribute to varying efficacy of topical, local anaesthetics in neonates.","volume":"6","author":"Larsson","year":"1996","journal-title":"Pediatr Anaesth"},{"key":"2021121010115181700_B7","doi-asserted-by":"crossref","first-page":"1012","DOI":"10.1542\/peds.74.6.1012","article-title":"Pacifying effects of nonnutritive sucking on term and preterm neonates during heelstick procedures.","volume":"74","author":"Field","year":"1984","journal-title":"Pediatrics"},{"key":"2021121010115181700_B8","doi-asserted-by":"crossref","first-page":"332","DOI":"10.1203\/00006450-199509000-00010","article-title":"Sucrose reduces pain reaction to heel lancing in preterm infants: a placebo-controlled, randomized and masked study.","volume":"38","author":"Bucher","year":"1995","journal-title":"Pediatr Res"},{"key":"2021121010115181700_B9","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1542\/peds.87.2.215","article-title":"Sucrose as an analgesic for newborn infants.","volume":"87","author":"Blass","year":"1991","journal-title":"Pediatrics"},{"key":"2021121010115181700_B10","doi-asserted-by":"crossref","first-page":"F177","DOI":"10.1136\/fn.70.3.F177","article-title":"Alleviation of the pain of heel prick in preterm infants.","volume":"70","author":"McIntosh","year":"1994","journal-title":"Arch Dis Child"},{"key":"2021121010115181700_B11","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1136\/adc.58.3.226","article-title":"Making heel pricks less painful.","volume":"58","author":"Harpin","year":"1983","journal-title":"Arch Dis Child"},{"key":"2021121010115181700_B12","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1016\/0304-3959(90)91142-6","article-title":"Neonatal facial and cry responses to invasive and noninvasive procedures.","volume":"42","author":"Grunau","year":"1990","journal-title":"Pain"},{"key":"2021121010115181700_B13","doi-asserted-by":"crossref","first-page":"395","DOI":"10.1016\/0304-3959(87)90073-X","article-title":"Pain expression in neonates: facial reaction and cry.","volume":"28","author":"Grunau","year":"1987","journal-title":"Pain"},{"key":"2021121010115181700_B14"},{"key":"2021121010115181700_B15","doi-asserted-by":"crossref","first-page":"F174","DOI":"10.1136\/fn.70.3.F174","article-title":"Behavioral response to pain in healthy neonates.","volume":"70","author":"Rushforth","year":"1994","journal-title":"Arch Dis Child"},{"key":"2021121010115181700_B16","first-page":"18","article-title":"Physiologic responses to cutaneous pain in neonates.","volume":"6","author":"Brown","year":"1987","journal-title":"Neonatal Network."},{"key":"2021121010115181700_B17","doi-asserted-by":"crossref","first-page":"F47","DOI":"10.1136\/fn.72.1.F47","article-title":"Exposure to invasive procedures in neonatal intensive care unit admissions.","volume":"72","author":"Barker","year":"1995","journal-title":"Arch Dis Child."},{"key":"2021121010115181700_B18","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1016\/0304-3959(89)90172-3","article-title":"Cutaneous hypersensitivity following peripheral tissue damage in newborn infants and its reversal with topical anesthesia.","volume":"39","author":"Fitzgerald","year":"1989","journal-title":"Pain"},{"key":"2021121010115181700_B19","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1016\/0304-3959(94)90128-7","article-title":"Pain sensitivity and temperament in extremely low-birth-weight premature toddlers and preterm and full-term controls.","volume":"58","author":"Grunau","year":"1994","journal-title":"Pain"},{"key":"2021121010115181700_B20","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1016\/0304-3959(94)90174-0","article-title":"Early pain experience, child and family factors, as precursors of somatization: a prospective study of extreme premature and fullterm infants.","volume":"56","author":"Grunau","year":"1994","journal-title":"Pain"},{"key":"2021121010115181700_B21"}],"container-title":["Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/101\/5\/882\/890201\/pe059800882o.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/101\/5\/882\/890201\/pe059800882o.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,1,14]],"date-time":"2024-01-14T05:06:12Z","timestamp":1705208772000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/pediatrics\/article\/101\/5\/882\/65316\/Venipuncture-Is-More-Effective-and-Less-Painful"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1998,5,1]]},"references-count":21,"journal-issue":{"issue":"5","published-online":{"date-parts":[[1998,5,1]]},"published-print":{"date-parts":[[1998,5,1]]}},"URL":"https:\/\/doi.org\/10.1542\/peds.101.5.882","relation":{},"ISSN":["1098-4275","0031-4005"],"issn-type":[{"value":"1098-4275","type":"electronic"},{"value":"0031-4005","type":"print"}],"subject":[],"published":{"date-parts":[[1998,5,1]]}}}