Sucrose as an Analgesic for Newborn Infants

Blass, Elliott M.; Hoffmeyer, Lisa B.

doi:10.1097/00132586-199112000-00033

Cited by 136 publications

(196 citation statements)

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“…This shows that 25% and 50% glucose when given orally are comparable in their analgesic effect and 10% glucose and EBM have a comparable analgesic effect. Our results are similar to the results of Blass et al [5], Haouari et al [6] and Ramenghi et al [7], the only difference being that all these studies had used sucrose solutions for analgesic.…”

Section: Discussionsupporting

confidence: 92%

“…Difference in all the parameters measured was highly significant (p<0.05), except for facial scores, between the control group and the test groups. Although the mechanisms mediating the effect of glucose could not be studied, many studies by different authors have shown a primary role of endogenous opioids in pain relief [2,5,16]. This study and previous studies on animals [16,17] suggest a pre-absorptive mechanism.…”

Section: Discussionsupporting

confidence: 53%

“…Various studies [5][6][7] have shown that infants given oral sucrose, cry less during heel pricks and these effects can be blocked by naltrexone, an opioid antagonist, suggesting a link between the orogustatory effect of sweet solution orally and endogenous opioid pathways. However, sterile solution of sucrose -a disaccharide, is not normally available in the nursery/postnatal ward.…”

Section: Discussionmentioning

confidence: 99%

“…Nonpharmacological intervention is a more feasible alternative. Various studies [5][6][7] have shown that administration of oral sucrose, a disaccharide, raises the pain threshold, presumably mediated by endogenous opioids and could be used for that purpose. However, sucrose is not routinely used in neonatal care and is not readily available in the neonatal nursery.…”

Section: Introductionmentioning

confidence: 99%

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Analgesic Effect of Oral Glucose in Neonates

Jatana¹,

Dalal²,

Wilson

2003

Medical Journal Armed Forces India

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The International Association for the Study of Pain, has defined pain as "an unpleasant sensory and emotional experience connected with actual or potential tissue damage or described in terms of such damage". It was thought that the newborn baby does not experience pain because of incompletely developed nervous system. However, it has been shown that neurological system known to be associated with pain transmission and modulation, is intact and functional. A study was conducted in our center to study the analgesic effect of administration of oral glucose in various concentrations, in neonates undergoing heel punctures, for collection of blood for investigations. This was compared with the analgesic effects of breast milk (which contains lactose). 125 full term normal neonates with no history of birth asphyxia or underlying neurological abnormality, requiring heel punctures for collection of blood for various investigations were selected for the study. They were matched for gestational age, birth weight and sex distribution and divided into 5 groups of 25 each. One group comprised control subjects and was administered sterile water. 3 groups were administered 1 ml of varying strengths of glucose solutions i.e. 10%, 25% and 50% respectively. The last group was given 1 ml of expressed breast milk (EBM). Prior to heel pricks, state of arousal, baseline heart rate (HR) and transcutaneous oxygen saturation (SpO 2 ) were recorded by pulse oximeter in each neonate. Autolet, a mechanical device for capillary sampling, was used for heel pricks to give equal strength of painful stimulus in each procedure. Audio tape recorder was used to record the cry. The oral solution was administered slowly over 30 seconds by means of a syringe placed in the mouth. Heel puncture was done after 2 minutes, taking all aseptic precautions. HR and SpO 2 were monitored using pulse oximeter. Pain response was assessed, by recording duration of crying, change in HR, change in SpO 2 and facial action score after the procedure. Mean duration of cry and total cry over 5 minutes was significantly less in groups given 25% and 50% glucose solutions as compared to the control group and babies given EBM. Difference in mean increase in HR, fall in SpO 2 were statistically significant between control group, EBM group and neonates given 25% and 50% glucose solutions respectively. Compared to control group, all other administered solutions (10%, 25%, 50% glucose and EBM) were found to reduce physiological and behavioral responses in neonates undergoing heel punctures. 25% and 50% glucose solutions were found to have maximal analgesic effect and both were found to be equally effective. EBM and 10% glucose solution have an equal analgesic effect but less than 25% or 50% glucose. This simple, cheap and safe method of oral analgesia can be easily used in neonates undergoing heel prick procedures during routine neonatal care. MJAFI 2003; 59 : 100-104

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 53%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Analgesic Effect of Oral Glucose in Neonates

Jatana¹,

Dalal²,

Wilson

2003

Medical Journal Armed Forces India

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“…Nos últimos anos, vem-se discutindo a utilização da água com açúcar como analgésico 12 . Demonstrou-se, em modelos animais, que o efeito analgésico da glicose pode ser revertido com antagonistas de opióides, o que sugere um mecanismo de ação envolvendo a liberação de endorfinas 13 .…”

Section: Solução Glicosadaunclassified

Sedação e analgesia em neonatologia

Silva¹,

Gomez²,

Máximo³

et al. 2007

Rev. Bras. Anestesiol.

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JUSTIFICATIVA E OBJETIVOS:A importância do estudo da dor em Neonatologia se deve ao fato de que a sensação de dor e estresse significa sofrimento e desconforto para os recém-nascidos e, apesar desse conhecimento, pouco tem sido feito para minimizá-los. Nessa revisão foram discutidas: a prevenção da dor, as medidas não-farmacológicas e farmacológicas para o seu tratamento e a sedação em recém-nascidos. CONTEÚDO:Várias são as medidas não-farmacológicas que podem ser tomadas com intuito de prevenir a dor nas Unidades de Terapia Intensiva Neonatal e também para tornar o ambiente mais humanizado e menos estressante para os pacientes e seus familiares. O tratamento da dor no recém-nascido consiste em medidas não-farmacológicas (sucção não-nutritiva, glicose) e farmacológicas (analgésicos não-opióides, opióides e anestésicos locais). A sedação em recém-nascidos é produzida por fármacos que agem diminuindo a atividade, a ansiedade e a agitação do paciente, podendo levar à amnésia de eventos dolorosos ou não-dolorosos. A sedação pode ser feita pela administração de hidrato de cloral, barbitúricos, propofol e benzodiazepínicos. CONCLUSÕES:A prevenção da dor e a indicação de analgesia devem ser individualizadas e sempre consideradas em todos os recém-nascidos portadores de doenças potencialmente dolorosas e/ ou submetidos a procedimentos invasivos, cirúrgicos ou não.

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