• P Saththasivam, D Umadevan, N Ramli, K Voralu, N N Naing, M I Ilias, N Shuib, B G Tan, and H van Rostenberghe.
• Paediatrics Department, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia.
• Singap Med J. 2009 Oct 1; 50 (10): 1004-7.

IntroductionThe aim of this study was to determine whether there was a difference in the pain indicators and effectiveness between venipuncture (VP) and heel prick (HP) for blood glucose monitoring in term neonates (recently, venipuncture was shown superior for the Guthrie test).Methods66 term neonates undergoing blood glucose monitoring underwent VP or HP. Primary outcome measures included the Neonatal Facial Scoring System (NFCS) score, duration of the first cry, total duration of cry and duration of procedure. Secondary outcome measured was the number of skin punctures needed to obtain blood.ResultsThe NFCS score was not significantly different between the two groups and the duration of the procedure was significantly longer for the VP than the HP group (median 27 s vs. 7 s; p-value is less than 0.001). The differences between the two groups in the duration of the first cry, total duration of cry and number of skin punctures needed to obtain blood were not statistically significant, but these parameters displayed a trend, favouring the HP.ConclusionThe HP is still the preferred method of drawing blood in neonates for blood glucose monitoring, as only one drop of blood is required.

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