Sucrose and Warmth for Analgesia in Healthy Newborns: An RCT

Gray, Laura; Garza, Elizabeth Zambrano; Zageris, Danielle M.; Heilman, Keri J.; Porges, Stephen W.

doi:10.1542/peds.2014-1073

Cited by 32 publications

(9 citation statements)

References 50 publications

(32 reference statements)

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“…The remaining 82,234 references were reviewed by 2 of the authors (V.S., A.T.) against the inclusion criteria. 9 Five studies were excluded after reviewing the full manuscript as it included: (1) combined interventions versus control (n=1) 17 ; (2) a no comparator group (n=2), 18 , 19 ; (3) did not include intervention according to the clinical question (n=1) 20 ; and (4) the procedure was SC injection of normal saline (n=1). 21…”

Section: Resultsmentioning

confidence: 99%

Pharmacological and Combined Interventions to Reduce Vaccine Injection Pain in Children and Adults

Shah

Taddio

McMurtry

et al. 2015

The Clinical Journal of Pain

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Section: Resultsmentioning

confidence: 99%

Pharmacological and Combined Interventions to Reduce Vaccine Injection Pain in Children and Adults

Shah

Taddio

McMurtry

et al. 2015

The Clinical Journal of Pain

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“…Their results showed that the sucrose plus warmer group cried and grimaced for 50% less time after the vaccination than the sucrose alone group and they also showed less physiological response to pain. 7 Many such studies have proved that oral dextrose (different concentrations have been used in different studies) reduced the crying time of infants experiencing procedural pain. [8][9][10][11] The other methods commonly used for management of pain include expressed breast milk, non-nutritive sucking or oral sucrose.…”

Section: Discussionmentioning

confidence: 99%

25% oral dextrose as analgesia during neonatal immunisation with BCG

Mundol¹,

Prabhu²,

Saldanha³

2018

Int J Contemp Pediatr

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Background: Various animal studies have shown that repeated painful exposures can have deleterious long-term effects on neonates. Sick newborns are exposed to multiple painful procedures such as venipunctures, suctioning even removal of plasters. There are various physiologic and behavioral indicators of pain used in various standardized pain scales such as NIPS, NFCS, FLACC scale and Wong-Baker Faces pain scale. Sucrose, as an analgesic, has been used and recommended for minor painful procedures in neonates. The optimal dose of oral sucrose has not been established. The objective of this study was to study the analgesic effect of oral administration of 2 ml of 25% oral dextrose during neonatal immunization with BCG vaccine using NIPS (Neonatal/Infant Pain Scale).Methods: 40 consecutively selected newborns were given 2 ml of 25% oral dextrose solution 2 minutes prior to receiving the routine intradermal BCG vaccination. 40 consecutively selected newborns served as controls. The pain response in both groups was assessed using the standardized Neonatal Infant Pain Scale (NIPS).Results: Of the total 80 neonates included in the study, 40 were included in the dextrose group and 40 served as controls. 77.5% of the dextrose group were term babies compared to 72.5% in the control group. 20% of the dextrose group showed a NIPS score ≥6 while 40% in the control group had a similar NIPS score. Conclusions: A total of 80 newborns were included in this study, of which 40 (22 males, 18 females) received 25% oral dextrose solution prior to the BCG vaccine. The group which received dextrose was found to have less indicators of pain such as change in breathing pattern, cry and facial expression.

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“…In Cochrane review done by Steven et al in July 2015, 14 it was concluded that sucrose is effective in reducing procedural pain in neonates without any serious side effects.…”

Section: Introductionmentioning

confidence: 99%

Implementing use of sucrose analgesia (non-pharmacological management of neonatal pain) in a standalone private facility level 3 neonatal care unit using point of care quality improvement methodology

Sawleshwarkar

Singh

Bajaj³

et al. 2022

BMJ Open Qual

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BackgroundNeonatal pain not only has negative impact on the acute physiological parameters of the neonate but also has got the potential to cause long-term neurodevelopmental disabilities. However, neonatal pain especially related to procedures is not well recognised and often poorly managed in neonatal intensive care unit (NICU).Local problemOral sucrose solution became available commercially in late 2017 and this provided us the opportunity to alleviate some of the procedural pain in neonates admitted in our NICU.MethodsPoint of care quality improvement method (POCQI) was leveraged to identify root causes, change ideas and solutions were tested using PDSA cycles. Four procedures were selected by team for sucrose analgesia namely intravenous cannula insertion, tracheal suctioning, removal of tapes and phlebotomy. Change ideas tested included training of staff and doctors, providing dosage chart in NICU, method of administration of sucrose, affixing sucrose vial to baby bed, using prefilled sucrose syringe and bedside availability of sucrose and checklist for documentation. The study was conducted over a period of 8 weeks from 15 June 2017 on all eligible babies getting admitted.AIM statementWe aim to increase compliance to administration of sucrose analgesia to all eligible newborns (undergoing 4 selected procedures intravenous cannula insertion, tracheal suctioning, removal of tapes and phlebotomy) in NICU prior to painful procedure from current 0% to >80% by 8 weeks.ResultsThis quality improvement study implementing the use of evidence-based sucrose analgesia using PDSA cycles found that percentage of babies getting sucrose analgesia has increased from baseline 0% to 96.27% in the study period and is sustained at >80% for 4 years.ConclusionsPOCQI methodology can be used effectively to implement a new simple strategy of administering oral sucrose solution to address procedural pain in care pathway of neonates admitted in NICU. Sustaining the gains achieved by POCQI needs active leadership involvement and addressing adaptive or behavioural challenges with solutions like team huddles.

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Sucrose and Warmth for Analgesia in Healthy Newborns: An RCT

Cited by 32 publications

References 50 publications

Pharmacological and Combined Interventions to Reduce Vaccine Injection Pain in Children and Adults

Pharmacological and Combined Interventions to Reduce Vaccine Injection Pain in Children and Adults

25% oral dextrose as analgesia during neonatal immunisation with BCG

Implementing use of sucrose analgesia (non-pharmacological management of neonatal pain) in a standalone private facility level 3 neonatal care unit using point of care quality improvement methodology

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