Oral Sucrose and Pain Relief for Preterm Infants

Anita Mitchell, RN, PhD, Patricia A. Waltman, RNC, EdD, NNP


Pain Manag Nurs. 2003;4(2) 

In This Article

Abstract and Introduction


The frequency of painful procedures performed on preterm infants in the neonatal intensive care unit (NICU) presents a challenge to nurses who are attempting to provide effective pain relief, and to the infants themselves who may suffer adverse consequences in response to repeated painful procedures. One new pain relief intervention under study is the administration of oral sucrose, which may activate endogenous opioid systems within the body. Studies with preterm infants that have examined the use of oral sucrose as an analgesic during heelsticks and venipunctures have shown that sucrose is effective in reducing pain. Sucrose may also be combined with nonnutritive sucking to provide significant pain relief. The use of oral sucrose is now recommended with a wide range of painful procedures in the NICU. Promising results have been observed in studies with both term and preterm infants, but less research has occurred with preterm infants. Additional research is warranted to determine the most effective approaches for the administration of sucrose, to examine the effectiveness of sucrose with additional types of painful procedures, and to examine the effects of long-term repeated use of sucrose.


Preterm infants need effective pain management during and after the frequent painful procedures that are performed in neonatal intensive care units (NICUs). It is a challenge for nurses who work in these areas to provide comfort to infants and to prevent and relieve pain during diagnostic and therapeutic procedures. The American Academy of Pediatrics (2000) states that "despite the advances in pain assessment and management, prevention and treatment of unnecessary pain attributable to anticipated noxious stimuli remain limited" (p. 2).

In recent years, nurses have placed increasing emphasis on developmentally sensitive care for preterm infants, recognizing the unique needs of these infants who may have difficulty coping with extrauterine life. Oral sucrose has been studied extensively in neonates and shows promise as a developmentally appropriate and effective means of relieving pain in preterm infants during procedures. The purpose of this article is to review the literature concerning the use of oral sucrose with preterm infants. This literature review will include physiologic mechanisms of sucrose action, current recommendations for sucrose use, and a critique of published studies involving the use of sucrose with preterm infants.


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