Oral glucose as an analgesic to reduce infant distress following immunization at the age of 3, 5 and 12 months

Thyr, M.; Sundholm, Anneli; Teeland, Lawrence; Rahm, Vivi-Anne

doi:10.1111/j.1651-2227.2007.00021.x

Cited by 37 publications

(21 citation statements)

References 30 publications

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“…The search yielded 695 citations, of which 14 RCTs, including a total of 1674 injections, met the inclusion criteria 11–24. The selection process is summarised in figure 1.…”

Section: Resultsmentioning

confidence: 99%

“…Five studies did not describe the generation of allocation sequence,11–13 18 23 but only two studies failed to report concealment of allocation 12 23. Knowledge of allocated intervention was adequately prevented in most studies, with the exception of two RCTs, in which outcome assessments were adequately blinded, but parents as well as the nurses administering injections were not blinded 22 24. The glucose solution could not be concealed in one study that compared two different sucrose concentrations, a 40% glucose solution and water 21.…”

Section: Resultsmentioning

confidence: 99%

“…In three studies, 30% glucose was utilised17 18 24 and in one study, the analgesic effects of two sucrose concentrations (25% and 50%) and 40% glucose were compared with water 21. Volumes of solutions given were mainly 2 ml or less, with the exception of one study where 10 ml of 25% sucrose was administered 22.…”

Section: Resultsmentioning

confidence: 99%

“…A meta-analysis was conducted with data pooled from three studies reporting incidence of cry following immunisation17 18 24 (N=243 infants). Results showed a 20% reduction in RR for crying for infants when administered 1–2 ml of 30% glucose (RR 0.80, 95% CI 0.69 to 0.93) (figure 5).…”

Section: Resultsmentioning

confidence: 99%

“…For the four studies which used glucose solutions,17 18 21 24 glucose effectively reduced pain during immunisation compared to water, highlighting that non-sucrose sweet solutions of sufficient concentration are analgesic. Administration of 30% oral glucose resulted in an RR for crying following immunisation of 0.80 and an NNTB of six infants (albeit with a wide CI of 3 to 20).…”

Section: Discussionmentioning

confidence: 99%

See 4 more Smart Citations

Efficacy of sweet solutions for analgesia in infants between 1 and 12 months of age: a systematic review

Harrison

Stevens

Bueno

et al. 2010

Archives of Disease in Childhood

114

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Objective To compare the effi cacy of oral sweet solutions to water or no treatment in infants aged 1-12 months during immunisation. Methods Randomised controlled trials (RCTs) were retrieved through internet searches or manual searches of reference lists. Search terms included newborn, infant, pain, sucrose and alternative names for sweet solutions. Summary estimates with 95% CIs were calculated and included relative risk (RR), risk difference (RD) and number needed to treat to benefi t (NNTB) for dichotomous outcomes, and weighted mean differences (WMD) for continuous outcomes. Where pooling of results was not possible, a narrative summary of study results is presented. Results Of the 695 studies identifi ed, 14 RCTs with 1674 injections met the inclusion criteria. Sucrose or glucose, compared to water or no treatment decreased crying during or following immunisation in 13 of the 14 studies. Infants receiving 30% glucose (three trials, 243 infants) had a decreased RR in crying incidence following immunisation (typical RR 0.80, 95% CI 0.69 to 0.93; RD −0.17, 95% CI −0.29 to −0.05; NNTB 6, 95% CI 3 to 20). With sucrose or glucose, there was a 10% WMD reduction in proportion of crying time (95% CI −18 to −2) and a 12 s reduction in crying duration (95% CI −23 to −0.7 s). An optimal dose of sucrose or glucose could not be ascertained due to the varied volumes and concentrations used. Conclusion Infants aged 1-12 months administered sucrose or glucose before immunisation had moderately reduced incidence and duration of crying. Healthcare professionals should consider using sucrose or glucose before and during immunisation. BACKGROUNDExtensive research shows that oral sucrose, glucose and other sweet tasting solutions are effective analgesics during minor painful procedures in neonates. 1 2 The administration of sweet solutions (in particular sucrose and glucose) is now widely recommended for routine use prior to painful procedures in newborn infants. [3][4][5][6][7] Although the analgesic effect of sucrose and glucose on newborns is well established, little is known about whether these solutions or other sweet tasting solutions are effective in reducing procedural pain in infants beyond the newborn period. This gap in knowledge was the subject of a recent narrative literature review of 10 published randomised controlled trials (RCTs) in which confl icting results across studies were highlighted. 8 A systematic review and meta-analyses were recommended to ascertain whether current evidence supports the use of sweet solutions for pain management beyond the neonatal period. Therefore, the aim of our study was to conduct a systematic review and metaanalyses on the effectiveness of sweet solutions during painful procedures for infants beyond the neonatal period up to 12 months of age. METHODS Ethics approvalAs this was a systematic review of RCTs already completed, with no research activities involving humans, there was no requirement for ethics committee approval. Sources of dataWe followed the methods for cond...

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“…The search yielded 695 citations, of which 14 RCTs, including a total of 1674 injections, met the inclusion criteria 11–24. The selection process is summarised in figure 1.…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Efficacy of sweet solutions for analgesia in infants between 1 and 12 months of age: a systematic review

Harrison

Stevens

Bueno

et al. 2010

Archives of Disease in Childhood

114

View full text Add to dashboard Cite

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Sweet-tasting solutions for needle-related procedural pain in infants one month to one year of age

Kassab

Foster

Foureur

et al. 2012

Cochrane Database of Systematic Reviews

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The Cochrane Library and procedural pain in children: an overview of reviews

Curtis

Wingert

Ali

2012

Evid.‐Based Child Health

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BackgroundProcedural pain in children is highly prevalent, a major source of pain, stress and anxiety, and can have negative short‐ and long‐term effects. Research addressing effective pain management strategies is complex, presenting challenges for clinically relevant synthesis.ObjectiveTo summarize Cochrane reviews assessing the effects of various interventions used for pain in non‐neonatal children undergoing painful medical procedures.MethodsThe Cochrane Database of Systematic Reviews was systematically searched for reviews of interventions for pain in children outside of the neonatal period, undergoing painful medical procedures. The type of data to be extracted was determined a priori, and a single author performed data extraction. The Cochrane Library was searched using the terms ‘procedural pain’ and ‘procedures’. Reviews examining acute procedural pain in older infants, children and adolescents were included. Interventions included topical anaesthetics (eutectic mixture of local anaesthetics and amethocaine), sweet tasting substances, cognitive therapy, behavioural therapy and combined cognitive‐behavioural therapy(CBT). Data on self‐reported, behavioural and observer pain intensity and pain distress were extracted.Main resultsFour systematic reviews were included in the overview. There was evidence that self‐reported pain [risk ratio (RR) 0.63; 95% confidence interval (CI) 0.45–0.87], behavioural measures of pain (RR 0.71; 95% CI 0.52–0.96) and all pain scales combined (RR 0.69; 95% CI 0.55–0.87) were significantly less with amethocaine than with eutectic mixture of local anaesthetics. Results of trials of other interventions are reported in this article but heterogeneity of the combined effects is high.Authors' conclusionsAmethocaine provides superior pain relief when compared with eutectic mixture of local anaesthetics for the procedure of intravenous cannulation. From the data contained in this overview, there is no current evidence of benefit supporting the use of 12% sucrose for older infants and toddlers or sweet gum for toddlers undergoing needle pain. Potentially efficacious nonpharmacological interventions may include distraction, hypnosis, combined cognitive‐behavioural interventions, non‐nutritive sucking and video distraction; however, further research is required as results are mixed. An integrated approach using multiple modalities encompassing both the physiological and psychological aspects of pain is compelling and warrants further study in paediatrics. Copyright © 2012 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. The Cochrane Collaboration

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Oral glucose as an analgesic to reduce infant distress following immunization at the age of 3, 5 and 12 months

Abstract: Sweet solution can be used as a simple and safe method to reduce the distress following immunization in infants up to 12 months.

Cited by 37 publications

References 30 publications

Efficacy of sweet solutions for analgesia in infants between 1 and 12 months of age: a systematic review

Efficacy of sweet solutions for analgesia in infants between 1 and 12 months of age: a systematic review

Sweet-tasting solutions for needle-related procedural pain in infants one month to one year of age

The Cochrane Library and procedural pain in children: an overview of reviews

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