Venepuncture versus heel lance for blood sampling in term neonates
Abstract
Rationale: Reducing procedural pain is a key priority in neonatal care, as even routine procedures for blood sampling can cause significant discomfort and pain to the neonate. This systematic review aims to compare venepuncture and heel lance for blood sampling, focusing on pain response, to guide clinical practice.
Objectives: To evaluate the benefits (degree of pain) and harms (need for more than one skin puncture) of venepuncture compared to heel lance in term neonates.
Search methods: We searched CENTRAL, MEDLINE, Embase, two trial registries and conference abstracts, and checked references of included studies and related systematic reviews up to 04 July 2025.
Eligibility criteria: We included randomized controlled trials (RCTs) and quasi-RCTs that compared pain response from venepuncture versus heel lance. Neonates could receive a sweet-tasting solution (such as glucose or sucrose), which is a commonly used analgesic in neonates for pain relief. We excluded studies that reported on pain using physiological parameters in isolation, as they are reflective of overall clinical status and non-specific arousal.
Outcomes: Our outcomes of interest were pain reported using validated pain scores (measured using one or more of the following scales: Neonatal Facial Coding System, Neonatal Infant Pain scores, or the Premature Infant Pain Profile) and the need for more than one skin puncture.
Risk of bias: We used the Risk of bias 1 (RoB) tool to assess bias in the included RCTs.…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 488 participants or records.
Read the paper
Related studies
- Regulation of nucleolus assembly by non-coding RNA polymerase II transcripts
- For a Healthy Histone Code, a Little SUMO in the Tail Keeps the Acetyl Away
- Discovering a binary CTCF code with a little help from BORIS
- Article Commentary: Stabilizing the Code–-Methods to Preserve RNA Prove Their Worth
- Foreword to the Special Issue for the RINTC (The Implicit Seismic Risk of Code-Conforming Structures) Project
- Commentary: Promoting Health and Well-being in Pediatric Primary Care Settings: Using Health and Behavior Codes at Routine Well-child Visits
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.