Effect of Sucrose Analgesia, for Repeated Painful Procedures, on Short-term Neurobehavioral Outcome of Preterm Neonates: A Randomized Controlled Trial

Banga, Shreshtha; Datta, Vikram; Rehan, Harmeet Singh; Bhakhri, Bhanu Kiran

doi:10.1093/tropej/fmv079

Cited by 27 publications

(14 citation statements)

References 13 publications

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“…Johnston [ 26 , 31 ] reported that 107 preterm infants < 31 weeks GA who were exposed to > 10 doses of sucrose per day in the first 7 days of life, after which time no pain relief was used, were more likely to exhibit poorer attention and motor development on the Neurobehavioral Assessment of Preterm Infants (NAPI) scale in the early months of life. Conversely, Banga [ 32 ] reported that of 93 neonates randomized to either repeated doses of sucrose or water for painful procedures for 7 consecutive days, there were no significant differences in NAPI scores or adverse events. Stevens [ 27 ] found no statistically significant differences between sucrose plus pacifier, water plus pacifier, or the standard care group on neurobiological risk status outcomes.…”

Section: Discussionmentioning

confidence: 99%

The minimally effective dose of sucrose for procedural pain relief in neonates: a randomized controlled trial

et al. 2018

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BackgroundOrally administered sucrose is effective and safe in reducing pain intensity during single, tissue-damaging procedures in neonates, and is commonly recommended in neonatal pain guidelines. However, there is wide variability in sucrose doses examined in research, and more than a 20-fold variation across neonatal care settings. The aim of this study was to determine the minimally effective dose of 24% sucrose for reducing pain in hospitalized neonates undergoing a single skin-breaking heel lance procedure.MethodsA total of 245 neonates from 4 Canadian tertiary neonatal intensive care units (NICUs), born between 24 and 42 weeks gestational age (GA), were prospectively randomized to receive one of three doses of 24% sucrose, plus non-nutritive sucking/pacifier, 2 min before a routine heel lance: 0.1 ml (Group 1; n = 81), 0.5 ml (Group 2; n = 81), or 1.0 ml (Group 3; n = 83). The primary outcome was pain intensity measured at 30 and 60 s following the heel lance, using the Premature Infant Pain Profile-Revised (PIPP-R). The secondary outcome was the incidence of adverse events. Analysis of covariance models, adjusting for GA and study site examined between group differences in pain intensity across intervention groups.ResultsThere was no difference in mean pain intensity PIPP-R scores between treatment groups at 30 s (P = .97) and 60 s (P = .93); however, pain was not fully eliminated during the heel lance procedure. There were 5 reported adverse events among 5/245 (2.0%) neonates, with no significant differences in the proportion of events by sucrose dose (P = .62). All events resolved spontaneously without medical intervention.ConclusionsThe minimally effective dose of 24% sucrose required to treat pain associated with a single heel lance in neonates was 0.1 ml. Further evaluation regarding the sustained effectiveness of this dose in reducing pain intensity in neonates for repeated painful procedures is warranted.Trial registrationClinicalTrials.gov: NCT02134873. Date: May 5, 2014 (retrospectively registered).

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Section: Discussionmentioning

confidence: 99%

The minimally effective dose of sucrose for procedural pain relief in neonates: a randomized controlled trial

et al. 2018

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“…Interestingly, Stevens et al showed that preterm infants <31 weeks’ gestational age who received >10 doses of sucrose per 24 h in the first week of life had poorer neurologic development compared with infants who received fewer sucrose doses [ 12 ]. However, in older premature neonates that are over 32 weeks gestational age, Banga et al showed that repeated dosages of sucrose administration for procedural pain in premature infants for the first seven days after enrollment had no significant impact on neurobehavioral outcomes at 40 weeks post conception [ 94 ]. Additional studies are required to clarify the effect of sucrose analgesia on the newborn’s brain.…”

Section: Sucrose and Stress Reliefmentioning

confidence: 99%

The Energy Costs of Prematurity and the Neonatal Intensive Care Unit (NICU) Experience

2018

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Premature neonates are in an energy deficient state due to (1) oxygen desaturation and hypoxia events, (2) painful and stressful stimuli, (3) illness, and (4) neurodevelopmental energy requirements. Failure to correct energy deficiency in premature infants may lead to adverse effects such as neurodevelopmental delay and negative long-term metabolic and cardiovascular outcomes. The effects of energy dysregulation and the challenges that clinicians in the Neonatal Intensive Care Unit (NICU) face in meeting the premature infant’s metabolic demands are discussed. Specifically, the focus is on the effects of pain and stress on energy homeostasis. Energy deficiency is a complex problem and requires a multi-faceted solution to promote optimum development of premature infants.

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“…21,22 Sex ratio among the cases in the present study was 1.27:1 and in controls was 1.08:1 which is comparable to studies done by Shreshta banga et al, (1.13:1) and A Ravishankar et al, (1:1). 21,23 Mean birth weight among cases in the present study was 2.96 kilograms(kgs) and in controls was 2.78 kgs. The mean birth weight was higher in cases than in controls which may be attributed to higher mean gestational age among cases.…”

Section: Discussionmentioning

confidence: 47%

Effect of oral 25% dextrose on pain relief in newborn infants undergoing venepuncture

Raju

Sudha

Shwetha

2020

Int J Contemp Pediatr

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Background: Aim of this study was to study effect of oral 25% dextrose for pain relief in newborns undergoing venepuncture.Methods: This is a case control study conducted in NICU, Cheluvamba hospital attached to Mysore medical college and research institute during the period between September 2018 to November 2018. Babies with gestational age between 34 to 40 weeks of gestation who had clinical indication for blood sampling were included in the study. Neonates who are critically ill, suffered perinatal asphyxia and having congenital anomalies were excluded from the study. Hundred newborn babies admitted to NICU who had clinical indication for blood sampling were enrolled in the study. Study population were divided into 2 groups, dextrose (cases) and non-dextrose group (controls). The data analysis included gestational age, postnatal age, weight, sex, heart rate, oxygen saturation, crying time and behavioural pain assessment.Results: Mean pain score, crying time and heart rate at 5 minutes of venepuncture were studied in both the groups. Mean pain score in dextrose group was 2.68 and in non-dextrose group was 7.18 with significant p value of 0.0062. Mean crying time in dextrose group was 8.98 minutes and in non-dextrose group was 42 minutes with significant p value of 0.001. Mean heart rate in dextrose group was 142 beats/minute and in non-dextrose group was 146bpm with p value of 0.08.Conclusions: Pain in the newborns should be recognised and adequately treated. Lingual 25% dextrose can be used as safe and effective analgesia in neonates undergoing minor invasive procedures like venepuncture.

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Effect of Sucrose Analgesia, for Repeated Painful Procedures, on Short-term Neurobehavioral Outcome of Preterm Neonates: A Randomized Controlled Trial

Cited by 27 publications

References 13 publications

The minimally effective dose of sucrose for procedural pain relief in neonates: a randomized controlled trial

The minimally effective dose of sucrose for procedural pain relief in neonates: a randomized controlled trial

The Energy Costs of Prematurity and the Neonatal Intensive Care Unit (NICU) Experience

Effect of oral 25% dextrose on pain relief in newborn infants undergoing venepuncture

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