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

Summary of Research and Need for Continued Research

Several RCTs have provided evidence that oral sucrose does give significant pain relief in preterm infants during heelsticks and venipunctures. The seven oral sucrose studies presented in Table 1 have all used random assignment of infants to treatment groups, blinding of the intervention, blinding of outcome measurement, and standardization of the data collection processes. Some studies have been limited by possibly invalid pain measurement and insufficient attention to contextual factors. Future research must address these issues, and continue to ensure rigor in the methodology. Overall, there is sufficient evidence to recommend the use of oral sucrose during procedures, but there is also a need for continued research in this area.

Questions remain concerning comparisons of the effectiveness of sucrose with alternative interventions, and combinations of sucrose with additional behavioral or pharmacologic interventions. Research is also needed to investigate clinical outcomes of using sucrose for pain management over the course of an entire hospital stay, and to determine whether any adverse effects occur as a result of repeated doses of sucrose.

Based on a study that examined neurological functioning of preterm infants who received repeated doses of sucrose during the first week of life, (Johnston et al. 2002) do not recommend the repeated use of sucrose for infants less than 32 weeks of age. Higher doses of sucrose for infants who were less than 31 weeks' gestational age were predictive of lower scores on the Neurobehavioral Assessment of the Premature Infant (NAPI) test, and higher scores on the Neuro-Biological Risk Score. More research is needed in this area.

An important area for future research will be to examine the effectiveness of oral sucrose for procedures other than heelsticks and venipunctures. Currently, all published studies address the effectiveness of sucrose only during heelsticks and venipunctures. Preterm infants undergo a variety of painful procedures on a daily basis, and the effectiveness of oral sucrose during more complex or prolonged procedures needs to be examined.


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