Neonatal Circumcision

Herschel, Marguerite; Khoshnood, Babak; Ellman, Carol; Maydew, Noemi; Mittendorf, Robert

doi:10.1001/archpedi.152.3.279

Cited by 58 publications

(3 citation statements)

References 23 publications

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“…It has also been reported that oral sucrose via a nipple is effective for pain relief in neonatal circumcision. 11 We consider, however, that this analgesic effect may be essentially due to the pacifier more than to sucrose itself.…”

Section: Discussionmentioning

confidence: 95%

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Randomised trial of analgesic effects of sucrose, glucose, and pacifiers in term neonates

Carbajal

Chauvet

Couderc

et al. 1999

BMJ

290

201

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Objectives To assess and compare the analgesic effects of orally administered glucose and sucrose and pacifiers. To determine the synergistic analgesic effect of sucrose and pacifiers. Design Randomised prospective study with validated behavioural acute pain rating scale. Setting Maternity ward. Participants 150 term newborns undergoing venepuncture randomly assigned to one of six treatment groups: no treatment; placebo (2 ml sterile water); 2 ml 30% glucose; 2 ml 30% sucrose; a pacifier; and 2 ml 30% sucrose followed by a pacifier. Results Median (interquartile) pain scores during venepuncture were 7 (5-10) for no treatment; 7 (6-10) for placebo (sterile water); 5 (3-7) for 30% glucose; 5 (2-8) for 30% sucrose; 2 (1-4) for pacifier; and 1 (1-2) for 30% sucrose plus pacifier. Mann-Whitney U test P values for comparisons of 30% glucose, 30% sucrose, pacifier, and 30% sucrose plus pacifier versus placebo (sterile water) were 0.005, 0.01, < 0.0001, and < 0.0001, respectively. Differences between group median pain scores for these comparisons were 2 (95% confidence interval 1 to 4), 2 (0 to 4), 5 (4 to 7), and 6 (5 to 8), respectively. P values for comparisons of 30% glucose, 30% sucrose, and 30% sucrose plus pacifier versus pacifier were 0.0001, 0.001, and 0.06, respectively. Differences between group medians for these comparisons were 3 (2 to 5), 3 (1 to 5), and 1 (0 to 2), respectively. Conclusion The analgesic effects of concentrated sucrose and glucose and pacifiers are clinically apparent in newborns, pacifiers being more effective than sweet solutions. The association of sucrose and pacifier showed a trend towards lower scores compared with pacifiers alone. These simple and safe interventions should be widely used for minor procedures in neonates.

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Section: Discussionmentioning

confidence: 95%

“…The analgesic effects of sucrose have been reported in term and preterm newborn infants 7 – 11. Glucose and non-sucrose sweet tasting solutions have also been found to have analgesic effects 12 – 14…”

Section: Introductionmentioning

confidence: 99%

Randomised trial of analgesic effects of sucrose, glucose, and pacifiers in term neonates

Carbajal

Chauvet

Couderc

et al. 1999

BMJ

290

201

View full text Add to dashboard Cite

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“…Human studies have produced similar observations. Consumption of a sucrose solution alleviated pain reactions and decreased crying after painful procedures in newborns (Blass and Hoffmeyer, 1991;Smith et al, 1992;Blass and Shide, 1994;Smith and Blass, 1996;Herschel et al, 1998;Overgaard and Knudsen, 1999). In children (Miller et al, 1994) and adult male subjects (Kakeda et al, 2008), sweet substances increased pain threshold, whereas a number of other works have observed that in adults the intake of palatable foods may have analgesic properties (Miller et al, 1994;Mercer and Holder, 1997;Lewkowski et al, 2003).…”

Section: Introductionmentioning

confidence: 95%

Modulation of Pain Sensitivity by Chronic Consumption of Highly Palatable Food Followed by Abstinence: Emerging Role of Fatty Acid Amide Hydrolase

et al. 2020

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There is a strong relationship between palatable diet and pain sensitivity, and the cannabinoid and opioid systems might play an important role in this correlation. The palatable diet used in many animal models of obesity is the cafeteria (CAF) diet, based on human food with high sugar, salt, and fat content. In this study, we investigated whether long-term exposure to a CAF diet could modify pain sensitivity and explored the role of the cannabinergic system in this modification. Male Sprague-Dawley rats were divided into two groups: one fed with standard chow only (CO) and the other with extended access (EA) to a CAF diet. Hot plate and tail flick tests were used to evaluate pain sensitivity. At the end of a 40-day CAF exposure, EA rats showed a significant increase in the pain threshold compared to CO rats, finding probably due to up-regulation of CB1 and mu-opioid receptors. Instead, during abstinence from palatable foods, EA animals showed a significant increase in pain sensibility, which was ameliorated by repeated treatment with a fatty acid amide hydrolase inhibitor, PF-3845 (10 mg/kg, intraperitoneally), every other day for 28 days. Ex vivo analysis of the brains of these rats clearly showed that this effect was mediated by mu-opioid receptors, which were up-regulated following repeated treatment of PF-3845. Our data add to the knowledge about changes in pain perception in obese subjects, revealing a key role of CB1 and mu-opioid receptors and their possible pharmacological crosstalk and reinforcing the need to consider this modulation in planning effective pain management for obese patients.

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