Use of glucose for pain management in premature neonates: a systematic review and meta-analysis protocol

Abstract

IntroductionTherapeutic management of neonatal pain is essential to reduce changes in initial and subsequent development. Although glucose has been shown to be effective in relieving pain, concentrations and dosages remain to be standardised. The objective of this systematic review and meta-analysis is to identify the efficacy of glucose as an analgesic in preterm infants.Methods and analysisThe Web of Science, Science Direct, Scopus, Cochrane Central Register of Controlled Trials, ClinicalTrials.gov, PubMed, Medline, Latin American and Caribbean Health Sciences Literature and Embase databases will be researched for randomised studies published until December 2021. This systematic review and meta-analysis will include studies investigating the use of glucose for pain control in premature neonates. The primary outcome will be pain relief. Three independent reviewers will select the studies and extract the data from original publications. The risk of bias was assessed using the Cochrane risk of bias tool. Data synthesis will be performed using the Review Manager software (RevMan V.5.2.3). We will evaluate heterogeneity based on I2 statistics. In addition, quantitative synthesis will be performed if the included studies are sufficiently homogeneous.Ethics and disseminationEthical approval for the research will not be required for this systematic review. The results of this study will be published in an international journal.Trial registration numberThis protocol was submitted to the International Prospective Register of Systematic Reviews (PROSPERO, number CRD42021236217).

Effect of Non-Pharmacological Methods in the Reduction of Neonatal Pain: Systematic Review and Meta-Analysis

“…Specifically, of the three variables analysed, the PIPP score achieved the best results, although this systematic review was underpowered to detect significant differences. Our statements are compatible with previously published articles, as the results on the efficacy of using this technique are not conclusive [ 56 , 57 , 58 ]. Some studies argue that the combination of oral sucrose and non-nutritive suctioning is associated with a reduction in the HR and PIPP scale and an increase in O 2 saturation [ 44 , 47 , 49 , 59 , 60 ].…”

“…In contrast, other studies show that such an intervention does not produce statistically significant differences when compared to routine care [ 45 , 48 , 50 ]. Furthermore, questions such as optimal dose and concentration or possible long-term adverse effects remain unresolved [ 50 , 57 , 58 ].…”

Parent-led neonatal pain management—a narrative review and update of research and practices

“…There is moderate certainty of evidence supporting the pain-relieving effect of a small amount of sweet solution that is given in the mouth prior to a painful procedure, as measured with composite pain scores. Sucrose is the most studied substance ( 59 , 51 ), followed by glucose ( 60 , 61 ) and comparisons between the effectiveness of the two substances are inconclusive ( 62 ). The effectiveness of sweet tasting solutions has been linked with the concentration, i.e., that it is sweet enough ( 63 ).…”

Excitatory and inhibitory neuronal signaling in inflammatory and diabetic neuropathic pain

“…On the opposite end of the connection between glucose levels and pain sensation is the observation that oral administration of glucose to newborn infants reduces painful reactions (Oliveira et al 2021 ), without affecting cellular ATP metabolism (Angeles et al 2020 ). Even if given orally against a control group of infants receiving breast milk, glucose was more effective in relieving pain (Varghese et al 2020 ).…”