Sucrose Analgesia: Identifying Potentially Better Practices

Lefrak, Linda; Burch, Kelly J.; Caravantes, Rheta; Knoerlein, Kim; DeNolf, Nancy; Duncan, J Matthews; Hampton, Frances; Johnston, Céleste; Lockey, Debbie; Martin-Walters, Cassandra; McLendon, Debra; Porter, M.D.; Richardson, Cliff; Robinson, Cathy; Toczylowski, Krystyna

doi:10.1542/peds.2006-0913r

Cited by 68 publications

(49 citation statements)

References 27 publications

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“…74 Maximum reductions in physiologic and behavioral pain indicators have been noted when sucrose was administered ∼2 minutes before a painful stimulus, and the effects lasted ∼4 minutes. [74][75][76] Procedures of longer duration, such as ophthalmologic examinations or circumcision, may require multiple doses of sucrose to provide continual analgesic effect. 76 In animal studies, the analgesic effects of sucrose appear to be a sweet-taste-mediated response of opiate, endorphin, and possibly dopamine or acetylcholine pathways; however, the mechanism of action is not well understood in human neonates.…”

Section: Pharmacologic Treatment Strategies Sucrose and Glucosementioning

confidence: 99%

Prevention and Management of Procedural Pain in the Neonate: An Update

Keels¹,

Sethna²,

Watterberg³

et al. 2016

Pediatrics

318

171

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The prevention of pain in neonates should be the goal of all pediatricians and health care professionals who work with neonates, not only because it is ethical but also because repeated painful exposures have the potential for deleterious consequences. Neonates at greatest risk of neurodevelopmental impairment as a result of preterm birth (ie, the smallest and sickest) are also those most likely to be exposed to the greatest number of painful stimuli in the NICU. Although there are major gaps in knowledge regarding the most effective way to prevent and relieve pain in neonates, proven and safe therapies are currently underused for routine minor, yet painful procedures. Therefore, every health care facility caring for neonates should implement (1) a pain-prevention program that includes strategies for minimizing the number of painful procedures performed and (2) a pain assessment and management plan that includes routine assessment of pain, pharmacologic and nonpharmacologic therapies for the prevention of pain associated with routine minor procedures, and measures for minimizing pain associated with surgery and other major procedures.

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Section: Pharmacologic Treatment Strategies Sucrose and Glucosementioning

confidence: 99%

Prevention and Management of Procedural Pain in the Neonate: An Update

Keels¹,

Sethna²,

Watterberg³

et al. 2016

Pediatrics

318

171

View full text Add to dashboard Cite

show abstract

“…The most often cited causes for this paradox are the several myths surrounding the painful experience in the neonatal population, particularly the perception that the newborn is too immature to feel pain [5]. It is known that the knowledge about the presence of pain in newborns has greatly increased among health providers who are responsible for neonatal care [6], but it is not known how each professional puts such knowledge into practice [7]. Young children including neonates do not have the ability to verbalize their pain thus health care providers must recognize their pain.…”

Section: Introductionmentioning

confidence: 99%

Sweet Solution Analgesia

Nuseir¹,

Kassab²,

Al-Azzani³

2017

Pain Relief - From Analgesics to Alternative Therapies

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“…[15][16][17] They promote self-regulation of the infant and provide oro-tactile, oro-gustatory, and tactile stimulation, capable of reducing infants' pain responses during most painful procedures. 15,[18][19][20][21] Sucrose is recommended extensively for pain relief in preterm infants [22][23][24] and has shown to be highly effective and safe for single procedures by Stevens et al 17 Sweet taste solutions seem to trigger endogenous opioid and nonopioid pathways. 25,26 FT is described as holding the infant by placing a hand on his or her hands and feet and by positioning the infant in a flexed midline position while in either a side-lying, supine, or prone position.…”

mentioning

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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Sucrose Analgesia: Identifying Potentially Better Practices

Cited by 68 publications

References 27 publications

Prevention and Management of Procedural Pain in the Neonate: An Update

Prevention and Management of Procedural Pain in the Neonate: An Update

Sweet Solution Analgesia

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

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