Effects of high dose orally administered paracetamol for heel prick pain in premature infants.

Objective: To evaluate whether high dose paracetamol (40 mg/kg orally) relieves pain in premature infants.

Methods: This study was a randomized controlled trial analyzing the effect of high dose oral paracetamol on pain response due to heel prick in 72 premature infants treated in the neonatal intensive care unit of Alzahra University Hospital, Isfahan, Iran during the period of April 2007 to August 2007. Ninety minutes before the heel prick, neonates received paracetamol orally in a dose of 40 mg/kg (Group 1) or an equal volume of placebo (Group 2). We assessed the pain using the premature infant pain profile (PIPP) score.

Results: Infants in the paracetamol and placebo groups had similar gestational ages (mean+/-SD: 31.7+/-1.7 versus 32.6+/-1.5) and birth weights (mean+/-SD: 1530+/-292 versus 1739+/-369). The mean+/-SD PIPP scores in Group 1 was 11.1+/-3.8 and in Group 2 was 9.7+/-4.2, (p=0.15).

Conclusion: Single high dose paracetamol does not appear to provide adequate analgesia for the acute pain caused by heel prick in premature neonates.