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

Questions Concerning Single Versus Repeated Doses of Sucrose

In clinical studies with human infants, researchers have typically given a single dose of sucrose before a procedure. The analgesic effect of sucrose lasts approximately 3 to 5 minutes (Blass et al., 1987), with the peak effect in 2 minutes (Blass & Shah, 1995). One double-blind RCT examined whether there was a difference between administration of a single dose of sucrose and administration of repeated doses of sucrose on preterm infant pain as measured by the Premature Infant Pain Profile (PIPP). The sample consisted of 48 infants between 25 and 34 weeks' gestational age. Three comparison groups were used during heelsticks as follows: three doses of 24% sucrose given by syringe 2 minutes before heelstick and every 2 minutes thereafter, one dose of 24% sucrose and two doses of sterile water given as above, and three doses of sterile water. All doses of sucrose and water were limited to a volume of .05 ml. The repeated sucrose group showed significant reductions in pain scores compared with the single sucrose group (p < .05) only in the last block of time measured (120 to 150 seconds). Background data were collected concerning each infant's medical history and severity of illness (Johnston, Stremler, Horton, & Friedman, 1999).

This study was the first to examine the effectiveness of repeated doses of sucrose to relieve pain for preterm infants during procedures. It would be important to extend the data collection time longer to determine the effectiveness of repeated doses in helping an infant to return to a baseline state, and to determine the need for repeated doses in painful procedures that last longer than a heelstick. A replication of the study using a larger sample size would also be helpful.


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