The Impact of Blood Sampling Site on Pain Score and on the Changes in Physiologic Indices in Preterm Infants: A Crossover Randomized Cinical Trial

Abstract

Abstract: Background: Blood sampling is a usual and painful procedure on preterm infant. Repeating painful procedures may affect the process of normal brain development and Pain management is important for nurses. Objectives: The present study was conducted to evaluate and compare pain score in two sites of blood sampling in preterm infants. Method: This crossover randomized clinical trial was conducted in the NICU of the Alzahra Teaching Hospital of Tabriz. The participants consisted of 105 preterm infants with 28-32 weeks of gestation, who needed blood sampling from veins during 4th to 8th days of their birth. They were allocated into two groups. Group 1(53 infants): venipuncture was performed at first on the scalp veins and after 24 hours of washout period the sampling repeated from dorsal hand veins. In the group 2(52 infants), the blood sample was taken first from hand veins and then, from the scalp. The pain score in the infants were evaluated by the ALPS-Neo (Astrid Lindgren Children’s Hospital Pain Scale) method. The data was analyzed by nested repeated measure model in SPSS 13 software. PV<0.05 was considered significant. Findings: The pain score was significantly higher while sampling was conducted from hand veins compared to scalp veins (p=0.001).The pain score was significantly higher in preterm infants with lower gestational age (28-30 weeks) than the infants with 30-32 weeks of gestation (p=0.048). Conclusion: The pain score in preterm infants according to ALPS-Neo method was significantly higher while sampling was conducted from hand veins compared to scalp veins . Preterm infants with lower gestational age had also higher pain score.