The effects of acupressure and foot massage on pain during heel lancing in neonates: A randomized controlled trial

•Pain in neonates due to procedures such as heel lance.•Acupressure and massage practices are reliable, easy to learn and apply and effective for pain control.•Acupressure and massage should be used as a practice to reduce procedural pain such as heel lancing in neonates. To determine the effects of foot massage and acupressure on pain during heel lancing in neonates. A randomized controlled trial was performed in a university hospital in Turkey between February and December 2018. The neonates were randomized into three groups as acupressure, massage, and control groups. Acupressure was applied to the neonates in the acupressure group, and massage was given to the neonates in the massage group for 2 min before the heel lancing procedure. Pain responses of the neonates in the groups was evaluated with the Neonatal Infant Pain Scale during and 1 min after the heel lancing procedure. The study was completed with 139 neonates including 46 neonates in the acupressure group, 47 neonates in the foot massage group, and 46 neonates in the control group. There were statistically significant differences between the acupressure, massage and control groups in terms of their mean NIPS scores during (4.30 ± 2.25, 3.95 ± 2.63, 6.04 ± 1.26; respectively) and 1 min after the heel lancing procedure (1.46 ± 1.46, 1.66 ± 1.66, 3.85 ± 1.37; respectively). There was a significant difference in NIPS scores between the intervention groups and the control groups (p = 0.001). Acupressure and massage were effective in reducing pain in neonates during the heel lancing procedure. However, there was no statistically significant difference between acupressure and massage. Acupressure and massage techniques can be applied for procedural pain management in the newborn.