Does noninvasive electrical stimulation of acupuncture points reduce heelstick pain in neonates?

Acta Paediatr. 2016 Dec;105(12):1434-1439. doi: 10.1111/apa.13581. Epub 2016 Sep 27.


Aim: Noninvasive electrical stimulation at acupuncture points (NESAP) for analgesia is used in children, but has not been widely studied in neonates. The purpose of this study was to determine whether NESAP alone or in combination with sucrose relieved heelstick pain in neonates.

Methods: Term neonates (n = 162) receiving routine heelsticks for newborn screening were enrolled following parental consent. All infants received facilitated tucking and non-nutritive sucking. Neonates were randomised to standard care, sucrose, NESAP or sucrose plus NESAP. NESAP (3.5 mA, 10 Hz) or sham was administered over four acupuncture points. The Premature Infant Pain Profile (PIPP), heart rate variability (HRV) and salivary cortisol were used to measure heelstick pain.

Results: PIPP scores among all four treatment groups increased during heelstick, F (9,119) = 1.95, p = 0.05 and NESAP therapy had no significant effect on PIPP scores. However, PIPP scores from baseline to heelstick increased the most in the two groups not receiving sucrose (p < 0.01). Mean PIPP scores remained below five during the heelstick in all four groups, indicating minimal or no pain. Differences in HRV and salivary cortisol among groups were insignificant.

Conclusion: NESAP at 3.5 mA, 10 Hz is not effective in relieving pain during heelsticks in neonates.

Keywords: NESAP; PIPP; Neonates; Pain; Sucrose.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Blood Specimen Collection / adverse effects*
  • Double-Blind Method
  • Electroacupuncture*
  • Humans
  • Infant, Newborn*
  • Neonatal Screening / adverse effects*
  • Pain / prevention & control*