Skin-to-Skin Contact and/or Oral 25% Dextrose for Procedural Pain Relief for Term Newborn Infants

Chermont, Aurimery Gomes; Falcão, Luiz Fábio Magno; Silva, Eduardo Henrique Laurindo de Souza; Balda, Rita de Cássia Xavier; Guinsburg, Ruth

doi:10.1542/peds.2009-0993

Cited by 105 publications

(70 citation statements)

References 30 publications

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“…[52][53][54][55][56][57] Kangaroo care 58,59 and breastfeeding [60][61][62][63][64] were more or equally effective, compared with sucrose alone, in most studies, with few exceptions. [65][66][67] Sucrose or glucose was equal to or more effective than eutectic mixture of topical anesthetics during heel lances, 68 finger pricks, 69 …”

Section: Additional Interventions Studiedmentioning

confidence: 99%

Analgesic Effects of Sweet-Tasting Solutions for Infants: Current State of Equipoise

et al. 2010

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OBJECTIVE: The goal was to review published studies of analgesic effects of sweet solutions, to ascertain areas with sufficient evidence of effectiveness and areas of uncertainty. METHODS: Databases searched included Medline, Embase, the Cumulative Index to Nursing and Allied Health Literature database, and PsycINFO, using the terms pain*, infant*, neonat*, newborn*, sucrose, glucose, and alternative sugars. Publications were sorted according to type, year, painful procedure studied, placebo/no-treatment groups, population studied, and country of publication. RESULTS: A total of 298 relevant unique publications involving human infants were identified; 125 (42%) were primary research studies, of which 116 (93%) were randomized controlled trials. Healthy preterm or term newborns were included in 82 studies (65%), and sick or very low birth weight infants were included in 22 (18%). Most studies included single episodes of painful procedures, with only 3 (2%) conducted over long periods. Procedures investigated most frequently were heel lance (49%), venipuncture (14%), and intramuscular injection (14%). Placebo or no-treatment groups were included in 111 studies (89%); in 103 (93%) of those studies, sweet solutions reduced behavioral responses, compared with placebo/ no treatment. CONCLUSION: Clinical equipoise relating to analgesic effects of sweet solutions no longer exists for single episodes of procedures for healthy preterm and term newborn infants. Uncertainties include outcomes after prolonged use of sweet solutions, concomitant use of other analgesics, and effectiveness beyond the newborn period. Future research should focus on addressing these knowledge and research gaps.

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Section: Additional Interventions Studiedmentioning

confidence: 99%

Analgesic Effects of Sweet-Tasting Solutions for Infants: Current State of Equipoise

et al. 2010

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“…The combination of 2 NPIs (eg, oral sucrose and FT) may have additive effects by stimulating infants in a multisensorial way to cope with the painful experience. 18,37,38 This study compared the impact of sucrose and FT alone and in combination on pain reactivity across multiple painful procedures. Randomized groups received oral sucrose, FT, and a combination of both strategies to evaluate possible additive effects.…”

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confidence: 99%

Oral Sucrose and “Facilitated Tucking” for Repeated Pain Relief in Preterms: A Randomized Controlled Trial

et al. 2012

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WHAT'S KNOWN ON THIS SUBJECT: Preterm infants are exposed to inadequately managed painful procedures during their NICU stay, which can lead to altered pain responses. Nonpharmacologic approaches are established for the treatment of single painful procedures, but evidence for their effectiveness across time is lacking. WHAT THIS STUDY ADDS:Oral sucrose with or without the added technique of facilitated tucking has a pain-relieving effect even in extremely premature infants undergoing repeated pain exposures; facilitated tucking alone seems to be less effective for repeated pain exposures over time.abstract OBJECTIVES: To test the comparative effectiveness of 2 nonpharmacologic pain-relieving interventions administered alone or in combination across time for repeated heel sticks in preterm infants. METHODS:A multicenter randomized controlled trial in 3 NICUs in Switzerland compared the effectiveness of oral sucrose, facilitated tucking (FT), and a combination of both interventions in preterm infants between 24 and 32 weeks of gestation. Data were collected during the first 14 days of their NICU stay. Three phases (baseline, heel stick, recovery) of 5 heel stick procedures were videotaped for each infant. Four independent experienced nurses blinded to the heel stick phase rated 1055 video sequences presented in random order by using the Bernese Pain Scale for Neonates, a validated pain tool.RESULTS: Seventy-one infants were included in the study. Interrater reliability was high for the total Bernese Pain Scale for Neonates score (Cronbach' s a: 0.90-0.95). FT alone was significantly less effective in relieving repeated procedural pain (P , .002) than sucrose (0.2 mL/kg). FT in combination with sucrose seemed to have added value in the recovery phase with lower pain scores (P = .003) compared with both the single-treatment groups. There were no significant differences in pain responses across gestational ages.CONCLUSIONS: Sucrose with and without FT had pain-relieving effects even in preterm infants of ,32 weeks of gestation having repeated pain exposures. These interventions remained effective during repeated heel sticks across time. FT was not as effective and cannot be recommended as a nonpharmacologic pain relief intervention for repeated pain exposure.

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“…Sources of repeated pain in the neonatal period are the invasive procedures needed to obtain bilirubin and glucose samples, testing blood for phenylketonuria, and administration of Vitamin K and Hepatitis B injections prior to discharge in healthy full term newborns. SSC has been confirmed as an effective non-pharmacologic pain reduction intervention when provided by the mother or father [13] [14], and when given alone [15] [16] [17] or in combination with breastfeeding [18], sucrose [19], and rocking [20]. SSC relieves pain from heel-stick [21] [22] [23], injection [15] [16] [24], or venipuncture [25].…”

Section: Introductionmentioning

confidence: 99%

Clustered Pain Procedures in Skin-to-Skin Contact (SSC) Position for Full Term Newborns

Kostandy¹,

Ludington‐Hoe²

2017

WJNS

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As a part of their routine care, full term newborns face many painful procedures immediately after birth and during the first couple days of life. Skin-toSkin Contact (SSC) has been recommended as a non-pharmacological pain management intervention in newborns. However, the use of SSC in labor and delivery rooms as well as in postnatal units and nurseries is limited due to the discomfort that the nurses and phlebotomists themselves experience during positioning the newborns and themselves to complete these routine procedures. The objective of this paper is to describe a step-by-step procedure that was developed and used in a randomized clinical trial to manage newborns pain during clustered pain procedures. The procedure worked well and no complaints of discomfort were reported by the nurses during the study.

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Skin-to-Skin Contact and/or Oral 25% Dextrose for Procedural Pain Relief for Term Newborn Infants

Abstract: Nonpharmacologic analgesic measures were effective for the treatment of procedural pain in term infants. The combination of oral 25% dextrose treatment and skin-to-skin contact acted synergistically to decrease acute pain in healthy neonates.

Cited by 105 publications

References 30 publications

Analgesic Effects of Sweet-Tasting Solutions for Infants: Current State of Equipoise

Analgesic Effects of Sweet-Tasting Solutions for Infants: Current State of Equipoise

Oral Sucrose and “Facilitated Tucking” for Repeated Pain Relief in Preterms: A Randomized Controlled Trial

Clustered Pain Procedures in Skin-to-Skin Contact (SSC) Position for Full Term Newborns

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