Systematic ReviewResearchPatient Education

Venepuncture probably reduced pain and repeat punctures versus heel lance in term newborns without sweet solutions

The Cochrane database of systematic reviews (PubMed)Jul 17, 2026

AI-summarized from the linked source. Educational brief, not medical advice.

Brief summary

An updated Cochrane review of eight randomized or quasi-randomized studies involving 826 term neonates found moderate-certainty evidence that venepuncture probably reduced procedural pain and repeat punctures versus heel lance when no sweet-tasting analgesic solution was used.

What NurseJet pulled from the source

This Cochrane review update compared venepuncture with heel lance for blood sampling in term neonates. Eight randomized or quasi-randomized studies with 826 infants were included, and overall risk of bias was judged high. Without a sweet-tasting solution, venepuncture probably reduced pain and the need for more than one puncture, based on moderate-certainty evidence. With a sweet-tasting solution, venepuncture may reduce pain, but evidence was low certainty, and the effect on repeat punctures was very uncertain. The findings depend on the analgesia context and do not replace neonatal sampling competency or pain-management protocols.

Why this matters for nurses

Pediatric and newborn nurses perform or support frequent blood sampling and assess procedural pain. This review distinguishes the evidence by sampling method and whether a sweet-tasting analgesic solution is used.

Bedside takeaway

Venepuncture probably reduced pain and repeat punctures without sweet solutions, but the evidence changes when analgesic solutions are used.

How This Applies in Practice

Use this when: Preparing to obtain a provider-ordered blood sample from a term neonate.

On your shift

Confirm the approved collection method and pain-management plan and ensure the clinician performing the procedure has the required competency.
Assess procedural pain, record the number of punctures, and escalate repeated unsuccessful attempts through the unit pathway.

Keep in mind: Do not choose a sampling or analgesia method from this review alone. Follow the neonatal protocol, facility policy, and patient-specific provider orders.

Key takeaways

The updated Cochrane review included eight studies and 826 term neonates.
Without a sweet-tasting solution, venepuncture probably reduced pain and repeat punctures versus heel lance.
With a sweet-tasting solution, pain evidence was low certainty and repeat-puncture evidence was very uncertain.
All eight studies had an overall high risk of bias, particularly around blinding and allocation concealment.

Practice implications

Before collecting a term newborn's sample, confirm the ordered test, approved collection method, staff competency, and neonatal pain-management plan. Use a validated pain assessment and document the number of punctures; escalate repeated unsuccessful attempts according to the unit pathway.

Limitations & cautions

The eight included studies had an overall high risk of bias and substantial pain-score heterogeneity. Evidence with sweet-tasting solutions was low or very low certainty, and the repeat-puncture estimate in that context was based on only 110 infants with a very wide confidence interval.
AI-summarized from the linked source. Review the original article before applying to practice.

Citations

Exact source links

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The Cochrane database of systematic reviews (PubMed)

The Cochrane database of systematic reviews (PubMed). Venepuncture versus heel lance for blood sampling in term neonates.

Open original source

https://pubmed.ncbi.nlm.nih.gov/42466545/

Professional education only

This summary does not replace clinical judgment, facility policy, provider orders, or official guidelines. Verify practice changes against the original source and local protocol.

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Journal of midwifery & women's health (PubMed)Sep 7, 2026Research Article

A retrospective analysis of US natality data found no statistically significant yearly difference in neonatal mortality between freestanding birth centers and hospitals among term, singleton, vertex births without major medical risk factors from 2015 through 2024.

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Research ArticleResearchPatient EducationAI summary · original source linked below

Adjusted neonatal-mortality odds for freestanding birth centers fluctuated around 1.0 across the 10-year study period. No individual year showed a statistically significant difference from hospital births, including 2020 and 2021 when birth-center volume increased.

Key takeaways

The analysis was restricted to births meeting selected low-risk criteria.
The study found no evidence that higher birth-center use during the pandemic years increased neonatal mortality.
The observational design cannot establish that birth setting itself caused the mortality pattern.

Why this matters on shift

The findings add national outcome data for counseling and systems planning around freestanding birth-center care for appropriately selected low-risk pregnancies.

Bedside takeaway

Apply local eligibility, surveillance, escalation, and transfer protocols when caring for planned low-risk birth-center patients.

Nursing implications

Keep eligibility, surveillance, escalation, and transfer decisions anchored to local birth-center criteria and maternal-newborn protocols.

Limitations & cautions

Abstract-only summary. The study used retrospective vital-record data, was limited to selected low-risk births, and cannot exclude residual differences between people who delivered in birth centers and hospitals.
AI-summarized from the linked source. Review the original article before applying to practice.

Citations · exact source links

Journal of midwifery & women's health (PubMed). Neonatal Mortality Risk Among Births in Freestanding Birth Centers, 2015 to 2024.

Open original sourceFull brief

AI-summarized from the linked source. Review the original article before applying to practice.

Pediatric emergency care (PubMed)Sep 7, 2026Research Article

A double-blind randomized trial found no reduction in vomiting or faster oral tolerance with intravenous pantoprazole versus placebo in children with acute gastroenteritis and persistent vomiting after ondansetron.

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Research ArticleResearchMedication SafetyAI summary · original source linked below

The trial randomized 100 children. Vomiting episodes and oral tolerance at 6 and 12 hours did not differ significantly, while median hospital stay was 2 days with pantoprazole and 1 day with placebo.

Key takeaways

The median participant age was 14 months, and 67% of participants were male.
Oral tolerance at 12 hours was 86% in both groups.
The longer stay associated with pantoprazole requires cautious interpretation because this was a single-center trial.

Why this matters on shift

The trial does not support empiric intravenous proton-pump inhibition for persistent vomiting in pediatric acute gastroenteritis after ondansetron.

Bedside takeaway

Clarify the indication for empiric acid suppression and keep hydration and oral-tolerance assessment central to care.

Nursing implications

Prioritize the ordered hydration and oral-tolerance plan, document ongoing emesis, and clarify the indication before administering empiric acid suppression.

Limitations & cautions

Abstract-only summary. This was a single-center study of 100 children in Tehran, and the abstract does not describe adverse events or explain why hospitalization was longer in the pantoprazole group.
AI-summarized from the linked source. Review the original article before applying to practice.

Citations · exact source links

Pediatric emergency care (PubMed). Effect of Intravenous Pantoprazole on Clinical Outcomes in Pediatric Acute Gastroenteritis: A Placebo-Controlled RCT.

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AI-summarized from the linked source. Review the original article before applying to practice.

Journal of neurology (PubMed)Sep 6, 2026Systematic Review

A cumulative meta-analysis found longer survival over time in Duchenne muscular dystrophy, alongside a shift from predominantly respiratory toward cardiac causes of death.

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Systematic ReviewResearchPatient EducationAI summary · original source linked below

The review included 53 studies and more than 13,000 patients. Pooled median survival was 29 years among ventilated patients and 19 years among non-ventilated patients, but these study-level observational comparisons do not establish that ventilation alone caused the difference.

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Sixty percent of patients in the included studies received home mechanical ventilation.
Survival improved progressively over time in both ventilated and non-ventilated groups.
As respiratory survival improved, cardiac and other causes accounted for a larger share of deaths.

Why this matters on shift

Patients living longer with Duchenne muscular dystrophy may need sustained respiratory support plus ongoing cardiac and multisystem surveillance across care transitions.

Bedside takeaway

Verify each patient's established respiratory and cardiac plan during admissions and care transitions.

Nursing implications

During admissions and handoffs, verify the established ventilation, airway-clearance, and cardiac-monitoring plan and coordinate concerns with the multidisciplinary team.

Limitations & cautions

Abstract-only summary. This was a study-level meta-analysis of heterogeneous observational survival reports; the ventilated and non-ventilated groups were not randomized, so associations should not be interpreted as treatment effects.
AI-summarized from the linked source. Review the original article before applying to practice.

Citations · exact source links

Journal of neurology (PubMed). Improving survival in Duchenne muscular dystrophy across eras: a systematic review and cumulative meta-analysis.

Open original sourceFull brief

AI-summarized from the linked source. Review the original article before applying to practice.

How This Applies in Practice

Key takeaways

Practice implications

Limitations & cautions

Exact source links

More updates for this clinical area

Low-risk birth-center births showed no higher neonatal mortality in a 10-year analysis

IV pantoprazole did not improve vomiting or oral tolerance in pediatric gastroenteritis

Duchenne survival has improved as respiratory and cardiac care evolved