Oral Sucrose and Pain Relief for Preterm Infants

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

Pain Manag Nurs. 2003;4(2)

Review of Studies Evaluating Sucrose for Pain Relief for Preterm Infants

The administration of oral sucrose as an analgesic for infants is a new approach in pain management, and it is important for nurses to examine the evidence that supports recommendations for sucrose use. Table 1 presents a summary of various randomized controlled trials that have examined the analgesic effect of sucrose during painful procedures in preterm infants. Selection of studies to be presented was based on inclusion in the Cochrane Database of Systematic Reviews (Stevens, et al., 2002). The following section presents a critique of studies that have examined the use of sucrose for pain relief in preterm infants. The studies are categorized according to the focus of the study or the specific questions addressed.

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Cite this: Oral Sucrose and Pain Relief for Preterm Infants - Medscape - Jun 01, 2003.

Abstract and Introduction
Physiologic Mechanisms and Background of Oral Sucrose
Recommendations for Using Sucrose to Provide Pain Relief for Preterm Infants
Review of Studies Evaluating Sucrose for Pain Relief for Preterm Infants
Effectiveness of Oral Sucrose as a Single Treament Before Painful Procedures
Questions Concerning Single Versus Repeated Doses of Sucrose
The Combination of Sucrose and Rocking
The Combination of Sucrose and Nonnutritive Sucking
Summary of Research and Need for Continued Research
Conclusion
References

Table 1. Table 1. Oral Sucrose and Pain Relief
Authors	Dose sucrose	Sample	Procedure	Pain Measure	Special Issues	Significant Results
Abad Diaz Domenech Robayna Rico, 1996	2 ml 12%2 ml 24%	28 infants <37 weeks	Venipuncture	Crying Physiologic data		Less crying with 24% group
Ramenghi Wood Griffith Levene, 1996	1 ml 25%	15 (crossover) 3234 weeks	Heelstick	Crying Heart rate Facial		Less crying and facial activity with sucrose
Bucher Moster Siebenthal Keel Wolf Duc, 1995	2 ml 50%	16 (crossover) 3336 weeks	Heelstick	Crying Physiologic data		Less crying Reduced increase in heart rate with sucrose
Johnston Stremler Stevens Horton, 1997	0.05 ml 24%	112 2534 weeks	Heelstick	Neonatal Facial Coding System Heart rate	Rocking Contextual factors	Less facial activity with sucrose
Johnston Stremler Horton Friedman, 1999	0.05 ml 24% every 2 min 3 times	48 2534 weeks	Heelstick	Premature Infant Pain Profile (PIPP)	Repeated doses versus single dose	Lower PIPP scores with repeated doses versus single dose
Stevens Johnston Franck Petryshen Jack Foster, 1999	Dipped pacifier (0.1 ml) 24%	128 (crossover) 2731 weeks	Heelstick	Premature Infant Pain Profile (PIPP)	Nonnutritive Sucking Positioning Contextual factors	Lower PIPP scores with pacifier and sucrose or water
Gibbins Stevens Hodnett Pinelli Ohlsson Darlington, 2002	0.5 ml 24%	190 2743 weeks	Heelstick	Premature Infant Pain Profile (PIPP)	Nonnutritive sucking	Lower PIPP scores with pacifier and sucrose

Table 1. Table 1. Oral Sucrose and Pain Relief
Authors	Dose sucrose	Sample	Procedure	Pain Measure	Special Issues	Significant Results
Abad Diaz Domenech Robayna Rico, 1996	2 ml 12%2 ml 24%	28 infants <37 weeks	Venipuncture	Crying Physiologic data		Less crying with 24% group
Ramenghi Wood Griffith Levene, 1996	1 ml 25%	15 (crossover) 3234 weeks	Heelstick	Crying Heart rate Facial		Less crying and facial activity with sucrose
Bucher Moster Siebenthal Keel Wolf Duc, 1995	2 ml 50%	16 (crossover) 3336 weeks	Heelstick	Crying Physiologic data		Less crying Reduced increase in heart rate with sucrose
Johnston Stremler Stevens Horton, 1997	0.05 ml 24%	112 2534 weeks	Heelstick	Neonatal Facial Coding System Heart rate	Rocking Contextual factors	Less facial activity with sucrose
Johnston Stremler Horton Friedman, 1999	0.05 ml 24% every 2 min 3 times	48 2534 weeks	Heelstick	Premature Infant Pain Profile (PIPP)	Repeated doses versus single dose	Lower PIPP scores with repeated doses versus single dose
Stevens Johnston Franck Petryshen Jack Foster, 1999	Dipped pacifier (0.1 ml) 24%	128 (crossover) 2731 weeks	Heelstick	Premature Infant Pain Profile (PIPP)	Nonnutritive Sucking Positioning Contextual factors	Lower PIPP scores with pacifier and sucrose or water
Gibbins Stevens Hodnett Pinelli Ohlsson Darlington, 2002	0.5 ml 24%	190 2743 weeks	Heelstick	Premature Infant Pain Profile (PIPP)	Nonnutritive sucking	Lower PIPP scores with pacifier and sucrose

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