Assessing Neonatal Pain, Duration of Crying and Procedure Time following Use of Automatic or Manual Heel Lances: A Randomized Controlled Study


The objective of this study was to compare neonatal pain, duration of crying and procedure time following use of automatic or manual heel lancets.


This randomized trial was conducted with neonates undergoing heel prick procedures in a neonatal intensive care unit for routine blood bilirubin monitoring. An information form, an observation form and the Neonatal Infant Pain Scale (NIPS) were used. Pain before, during and after (1 and 3 min) was assessed using NIPS scoring.


Seventy neonates were included (automatic lancet, n = 35; manual lancet, n = 35); there was no difference between the groups (p >0.01). Pain scores were significantly lower, with automatic lancets compared with manual lancets (p =0.001). The duration of crying after the procedure (p =0.001) and procedure time (p =0.001) was significantly shorter with automatic lancets compared with manual lancets.


Automatic heel lancets in neonates are more effective than manual lancets at reducing pain, and shorten the procedure time and duration of post-procedural crying.

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