Purpose: This study aimed to compare the pain-related behavioral and physiological responses and puncture-related characteristics between automated and laser lancets and examine the correlation between infants' pain-related responses and facial expressions during heel lancing in a neonatal intensive care unit. Methods: Pain-related responses were assessed using the Neonatal Infant Pain Scale, heart rate, and oxygen saturation through pulse oximetry. Facial expressions were also analyzed using a facial recognition application. Puncture-related characteristics were assessed through puncture marks, number of punctures, and hemostasis. Results: There was a significantly higher puncture mark frequency at 3 min in the automated lancet group than in the laser lancet group. There were no interaction effects of time and group on pain-related behavioral response, heart rate, or oxygen saturation. There were significant positive correlations between the pain-related behavioral response and anger, disgust, fear, and sadness. Conclusion: The laser lancet had relatively good outcomes regarding puncture-related characteristics, although there was no significant difference in pain-related responses. A laser lancet is a novel option for preterm babies at risk of scar-related inflammation and coagulopathies.
Keywords: Facial expression; hemostasis; pain; preterm babies; puncture.