Repeating a dose of sucrose for heel prick procedure in preterms is not effective in reducing pain: a randomised controlled trial

Lago, Paola; Cavicchiolo, Maria Elena; Mion, Teresa; Cengio, Valentina Dal; Allegro, Antonella; Daverio, Marco; Frigo, Anna Chiara

doi:10.1007/s00431-019-03509-2

Cited by 7 publications

(7 citation statements)

References 21 publications

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“…Preventing the changes of biobehavioral responses to painful procedures in neonates is a moral obligation for clinicians [1,5]. Although an understanding of infant pain continues to improve pain management, management of the changes of biobehavioral responses to short-term painful procedures has not been a focus [6]. The repeated exposure to pain can have negative short-and long-term effects [7], including adverse physiological, psychological and emotional consequences, [8,9], changes in pain threshold, and prolonged hyperalgesia, which have been associated with impaired brain development in later life [4].…”

Section: Introductionmentioning

confidence: 99%

Efficacy of Breast Milk Olfactory and Gustatory Interventions on Neonates’ Biobehavioral Responses to Pain during Heel Prick Procedures

Lin

Liaw

Chen

et al. 2022

IJERPH

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This study aimed to evaluate the efficacy of breast milk odor either alone or in combination with breast milk taste (via syringe-feeding) to alleviate neonates’ biobehavioral responses to pain during heel-prick procedures. This prospective randomized controlled trial recruited 114 neonates by convenience sampling from a newborn unit of a medical center in Taiwan. Neonates were randomly assigned to three groups: control (gentle touch + human voice), control + breast milk odor, and control + breast milk odor + breast milk taste. Heart rate, oxygen saturation, and voice recordings of crying were measured across heel-prick procedures: baseline, no stimuli (stage 0); during heel prick (Stages 1–4); and recovery (Stages 5–10). Generalized estimating equations and Kaplan–Meier survival analysis compared differences in changes between groups for heart rate, oxygen saturation, and time to crying cessation. Changes in mean heart rate and oxygen saturation in neonates receiving breast milk odor or breast milk odor + breast milk taste were significantly less than those at the corresponding stage for the control group. Among neonates receiving breast milk odor or breast milk odor + breast milk taste, hazard rate ratios for crying cessation were 3.016 and 6.466, respectively. Mother’s breast milk olfactory and gustatory interventions could stabilize the biobehavioral responses to pain during heel prick procedures in neonates.

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Section: Introductionmentioning

confidence: 99%

Efficacy of Breast Milk Olfactory and Gustatory Interventions on Neonates’ Biobehavioral Responses to Pain during Heel Prick Procedures

Lin

Liaw

Chen

et al. 2022

IJERPH

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“…The reported non-pharmacological management of procedural pain ranges between zero and 89% (1,2,25,39,40). The proportion of the respondents utilizing non-pharmacological measures in the present survey increased significantly between 2000 and 2019 from 84 to 97%.…”

Section: Non-pharmacological Approaches and Oral Sweet Solutionsmentioning

confidence: 64%

Changes in Physicians' Perceptions and Practices on Neonatal Pain Management Over the Past 20 Years. A Survey Conducted at Two Time-Points

et al. 2021

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Intense research for more than three decades expelled the view that neonates do not experience pain. The aim of this survey was to investigate whether the Greek physicians involved in neonatal intensive care have changed their perceptions regarding neonatal pain, adapting their management practices to the knowledge that have emerged in the past 20-years. This study is a survey conducted at two time-points, 20 years apart. Anonymous questionnaires were distributed to 117 and 145 physicians working in neonatal intensive care units (NICUs) all over Greece in years 2000 and 2019, respectively. The response rate was 90.6 and 80.7% in 2000 and 2019, respectively. All respondents, at both time-points, believed that neonates experience pain, which has serious acute and long-term consequences, while the vast majority considered analgesia-sedation (A-S) during painful interventions as obligatory. Utilization of NICU protocols and pain assessment tools remained low although increased significantly between 2000 and 2019. The use of systemic A-S postoperatively was high at both time-points, while its implementation in infants subjected to prolonged pain, specifically mechanical ventilation, increased significantly by 2019. Systemic or local analgesia for acute procedural pain was used by lower proportions of physicians in 2019, except for the tracheal intubation. In contrast, the use of sweet solutions and non-pharmacological measures prior to or during bedside procedures significantly increased over time. Opioid administration significantly increased, while a shift from morphine to fentanyl was observed. International literature and perinatal–neonatal congresses were stated as the main sources of updating physicians' knowledge and improving management practice on neonatal pain prevention and treatment. In conclusion, Greek NICU-physicians' perceptions that neonates can experience pain with potentially serious acute and long-term consequences remained strong over the past 20 years. Although physicians' practices on neonatal pain management improved, they are still suboptimal, while significant differences exist among centers. Continuing education, globally accepted management protocols, and readily applied pain assessment tools would further improve the management of procedural pain and stress in neonates.

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“…The Neosucrose study conducted by our group, demonstrated that a second dose of 24% sucrose was not superior to a single dose in reducing pain during the recovery phase of heel prick ( 9 ), but no studies compared these two pain control strategies for venipuncture.…”

Section: Short Communicationmentioning

confidence: 99%

“…Our study demonstrates that a second dose of sucrose significantly lower the pain scores of preterm infants receiving a venipuncture. A single dose a single dose of 24% sucrose with non-nutritive sucking administered before the procedure is as effective at reducing pain scores in response to both skin breaking procedures compared to two doses of 24% sucrose ( 9 ).…”

Section: Short Communicationmentioning

confidence: 99%

A Single Dose of Oral Sucrose Is Enough to Control Pain During Venipuncture: A Randomized Controlled Trial

Cavicchiolo¹,

Daverio²,

Battajon³

et al. 2022

Front. Pain Res.

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Sucrose is effective in reducing pain during minor procedures in neonates. We evaluated whether a second dose of sucrose was more effective than a single dose during venipuncture. We performed a randomised, double-blind, controlled trial at the NICU of Padua Hospital (August 2016-October 2017). We randomised 72 preterm infants undergoing venipuncture for routine test to a control group, which received a single standard dose of sucrose 2′ before the procedure and a placebo 30″ after the venipuncture, and an experimental group in which they received two doses of 24% sucrose 2′ before and 30″ after the venipuncture. No difference in pain perception was found between the groups at 30″, 60″ and 120″. In conclusion, we do not recommend a second dose of sucrose during venipuncture in prematures.

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Repeating a dose of sucrose for heel prick procedure in preterms is not effective in reducing pain: a randomised controlled trial

Cited by 7 publications

References 21 publications

Efficacy of Breast Milk Olfactory and Gustatory Interventions on Neonates’ Biobehavioral Responses to Pain during Heel Prick Procedures

Efficacy of Breast Milk Olfactory and Gustatory Interventions on Neonates’ Biobehavioral Responses to Pain during Heel Prick Procedures

Changes in Physicians' Perceptions and Practices on Neonatal Pain Management Over the Past 20 Years. A Survey Conducted at Two Time-Points

A Single Dose of Oral Sucrose Is Enough to Control Pain During Venipuncture: A Randomized Controlled Trial

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