Oral sucrose for analgesia in children aged between 3 months and 3 years undergoing transurethral bladder catheterisation: A randomised, double‐blinded, clinical trial

Abstract

Aim Many children admitted to hospital undergo invasive, painful and stressful procedures, including children who are not toilet trained undergoing transurethral bladder catheterisation (TUBC). Oral sucrose is commonly given to children to reduce procedural pain. In this study, we evaluated the effectiveness of oral sucrose in reducing procedural pain in children aged between 3 months and 3 years undergoing TUBC. Methods This study was a randomised, double‐blind, placebo‐controlled study conducted at Nepean Hospital, Sydney, Australia from June 2005 to June 2010. A total of 40 participants requiring TUBC for diagnostic evaluation were included. The participants were randomly assigned to receive 4 mL of 75% oral sucrose (n = 20) or a placebo (sterilised water) (n = 20). The primary outcomes were changes in two paediatric pain scale scores (the FLACC pain scale and the OUCHER pain scale), assessed by the parent/guardian(s), the doctor performing the TUBC and the nurse assisting. The secondary outcomes were physiological (changes in heart rate) and behavioural pain (crying) indicators. Results Of the outcome measures, 65% favoured the oral sucrose group, 31% favoured the placebo group, and 4% found no difference between the oral sucrose and placebo groups. Conclusion While the trends favouring the sucrose group in this study were encouraging, as the results were not statistically significant, there was insufficient evidence to demonstrate the effectiveness of oral sucrose in reducing procedural pain in children aged between 3 months and 3 years undergoing TUBC.

A randomized double-blind trial comparing the effect on pain of an oral sucrose solution versus placebo in children 1–3 months old needing bladder catheterization

“…To our knowledge, this is the first study to examine the effect of an oral sweet solution on pain during bladder catheterization in infants 1-3 months of age. Although the use of sweet solutions has been demonstrated highly efficacious during many painful procedures [7,32,33] in the newborn period (0-1 months), its effect in older infants is still controversial, with several studies demonstrating trends towards improvements in pain scores without achieving statistical significance [11][12][13][14][15].…”

“…In a study by Rogers et al sucrose did not achieve significant analgesia in infants less than 90 days undergoing bladder catheterization in the ED [13]. Similarly, London et al studied the effect of an oral sucrose solution in children 3 months to 3 years old who underwent bladder catheterization and found a trend in in reducing pain in the sucrose group without achieving statistical significance [14]. Although little is known regarding the long-term neurodevelopmental effects of sucrose in infants, most authors agree that sweet solutions display an overall safe profile and this is even more likely in the context of sporadic interventions, such as those conducted in the ED [16].…”

“…Also, studies suggest that sucrose should be administered to treat vaccine associated procedural pain in infants up to the age of 12 months [8][9][10]. However, data supporting the use of oral sweet solutions to decrease procedural pain in older children have shown conflicting results [11][12][13][14][15]. In a study by Curtis and al, sucrose demonstrated no effect on FLACC scores, crying time and heart rate in infants aged 0 to 6 months requiring venipuncture.…”