Analgesic Effect and Safety of Lidocaine Liposome vs Oral Sucrose Water in Blood Collection and Intramuscular Injection in Neonates.

Objective: To compare the analgesic effect of oral sucrose water (Su) vs local application of lidocaine liposome (LC) in blood collection and intramuscular injection in neonates.

Methods: A total of 300 neonates admitted to Sichuan Provincial People's Hospital in China between June 2019 and December 2021 who were to receive intramuscular injection and heel blood collection were enrolled in the study. The neonates were assigned to one of the following groups (n = 30 in each): control, 30% Su, 25% Su, 24% Su, 12% Su, 8% Su, LC 15-min, LC 30-min, LC 45-min or the combination group. The groups received different concentrations of Su or the application of LC liposome at different timepoints and the control group was given no analgesia. Before and after puncture, the Neonatal Facial Coding System-Revised (NFCS-R) was used for pain evaluation in the neonates. The heart rate (HR), respiratory rate, blood oxygen saturation (SpO2) and blood pressure (BP) in each group were compared, and the starting and ending time of crying and latent crying time were recorded and analyzed. After the optimal concentration of Su and optimal application time of LC were understood, the combination group was used to evaluate the analgesic effect of Su combined with LC.

Results: Using various concentrations of Su, neonate pain was alleviated to varying degrees; 24%, 25%, and 30% Su did not reveal any difference in various investigation items, although their effect was superior to 8% and 12% Su. The LC 30-min and LC 45-min groups performed better than the LC 15-min group with regard to NFCS-R score, vital signs and BP. However, no notable difference was observed between the LC 15-min and LC 45-min groups in latent time. Moreover, the combination of 24% Su and application of LC 30 minutes before puncture provided a better analgesic effect than a single anesthesia intervention.

Conclusion: The combination of 24% Su and the application of LC 30 minutes before puncture delivered better analgesic effect than a single anesthesia intervention alone.