• V Shah, A Taddio, and A Ohlsson.
• Women's College Hospital, Department of Newborn and Developmental Paediatrics, Faculty of Medicine, University of Toronto, Ontario, Canada.
• Arch. Dis. Child. Fetal Neonatal Ed. 1998 Nov 1; 79 (3): F209-11.

AimTo evaluate the effectiveness of paracetamol in decreasing the pain from heel prick.MethodsA prospective randomised double blind placebo controlled trial was conducted of 75 term neonates undergoing heel prick. Sixty to 90 minutes before the procedure neonates received paracetamol orally in a dose of 20 mg/kg (group 1) or an equal volume of placebo (group 2). Heel prick was performed in a standardised manner. Pain assessments were made using per cent facial action (brow bulge, eye squeeze, and nasolabial fold (range 0-300%) and per cent of time spent crying (range 0-100%).ResultsThirty eight neonates were enrolled in group 1 and 37 neonates in group 2. There were no significant differences in the demographic characteristics between groups. Mean gestational age was 39 (SD 1.4) vs 39.4 (SD 1.2) weeks, p = 0.86, mean birthweight 3.45 (SD 0.45) vs 3.44 (SD 0.42) kg; p = 0.31 for groups 1 and 2, respectively. Facial action pain scores did not differ between groups (143.5 (SD 54.2)% vs 131.1 (SD 59.6)%; p = 0.38). Cry scores also did not differ (29.4 (SD 19.9)% vs 26.8 (SD 20.2)%; p = 0.60). No adverse effects were observed.ConclusionParacetamol is ineffective for decreasing the pain from heel prick in term neonates.

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