To evaluate and compare the efficacy of combined sucrose and non-nutritive sucking for analgesia in newborns undergoing minor painful procedure: a randomized controlled trial

Thakkar, Pareshkumar A.; Arora, Kamaldeep; Goyal, Kanav; Das, Rashmi Ranjan; Javadekar, Bakul; Aiyer, Siddharth N.; Panigrahi, Sandeep Kumar

doi:10.1038/jp.2015.122

Cited by 35 publications

(41 citation statements)

References 12 publications

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“…Thakar P et al evaluated analgesic effect in newborns for combined use of sucrose and non-nutritive sucking while undergoing minor painful procedure. 20 The analgesic effect of sucrose occurs firstly by activation of central endogenous opioid system an action similar to that of opioid (e.g. morphine) analgesic.…”

Section: Discussionmentioning

confidence: 99%

Comparison of analgesic effect of 24% sucrose and breast milk in healthy infants less than 2 months of age

Kavthekar

Patil

Kurane

et al. 2016

Int J Contemp Pediatr

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INTRODUCTIONThe myth regarding neonatal pain suggests that because of neurological immaturity, neonates do not experience pain. However, studies have shown that pain pathways as well as cortical and subcortical centres, necessary for pain perception are well developed late in gestation and physiological and behavioural responses to pain are well documented in neonates.1 Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage. It is difficult to assess pain in infants, as infants cannot verbalise their pain ,as they are dependent on others to recognize it, intervene it, treat it. Many newborn babies undergo painful procedures like heel pricks, venepuncture and intramuscular injection for immunization, such procedures inflict distinct physiological, behavioral, hormonal and metabolic changes.3 Moreover painful experience very early in life can promote somatization later in life. 4 Dextrose and sucrose in varying concentration have been shown to relive pain during venepuncture or intramuscular injection. [5][6][7][8][9][10][11][12] Breastfeeding or expressed breast milk have ABSTRACT Background: Many newborns undergo painful procedures like heel pricks, venepuncture and intramuscular injection for immunization. The medical and paramedical staffs usually ignore pain felt during these procedures. The aim of this study was to compare analgesic activity of 24% sucrose solution with breast milk during 1st DPT vaccination using sterile water as placebo. Methods: This double blind, randomized placebo controlled trial was conducted in 150 healthy infants undergoing for their 1 st DPT vaccination. Infants were randomized in to three groups of 50 each and received sterile water, 24% sucrose and breast milk 2 minutes prior to vaccination. The outcome variables were total duration of cry, first cry, change in heart rate and modified facial coding score (MFCS). Results: Mean total cry was significantly lower in 24% sucrose babies 36.3 (25.34) seconds and breast milk babies 42.1 (26.13) seconds as compared to sterile water 137.2 (20.31) seconds. Mean first cry was significantly lower in 24% sucrose 18.2 (14.12) seconds and breast milk babies 25.1 (13.67) seconds as compared to sterile water 94.3 (23.26) seconds. Mean rise in heart rate (beats/min) at 3 minutes was significantly lower with 24% sucrose 3 (2.3)and breast milk 7.4 (4.6) as compared to sterile water 18.2 (4.61).Change in MFCS at 1min and 3 min was significantly lower in 24% sucrose and breast milk babies. Maximum reduction in total cry, first cry, lower rise in heart rate and low MFCS was with 24% sucrose as compared to breast milk group. Conclusions: 24% sucrose and breast milk had analgesic activity in infants less than two months of age undergoing DPT vaccination. The analgesic effect was better for 24% sucrose as compared to breast milk.

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Section: Discussionmentioning

confidence: 99%

Comparison of analgesic effect of 24% sucrose and breast milk in healthy infants less than 2 months of age

Kavthekar

Patil

Kurane

et al. 2016

Int J Contemp Pediatr

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“…* haematological parameters, blood chemistries and hormone levels; **any other health outcome, which couldn’t be classified to any of the above listed categories (e.g. male fertility [ 289 ], offspring forearm fractures [ 290 ], emotional state [ 291 ], analgesia [ 292 ] or mortality [ 293 ]). Abbreviations: AS, artificial sweeteners; CVD, cardiovascular disease; NNS, non-nutritive sweeteners …”

Section: Resultsmentioning

confidence: 99%

Health outcomes of non-nutritive sweeteners: analysis of the research landscape

Lohner

Toews

Meerpohl

2017

Nutr J

135

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BackgroundFood products containing non-nutritive sweeteners (NNSs) instead of sugar have become increasingly popular in the last decades. Their appeal is obviously related to their calorie-free sweet taste. However, with the dramatic increase in their consumption, it is reasonable and timely to evaluate their potential health benefits and, more importantly, potential adverse effects. The main aim of this scoping review was to map the evidence about health outcomes possibly associated with regular NNS consumption by examining the extent, range, and nature of research activity in this area.MethodsWe systematically searched Ovid MEDLINE, EMBASE and the Cochrane CENTRAL databases for studies on NNSs (artificial sweeteners or natural, non-caloric sweeteners, either used individually or in combination) using text terms with appropriate truncation and relevant indexing terms. All human studies investigating any health outcomes of a NNS intervention or exposure were eligible for inclusion. No studies were excluded based on language, study design or methodological quality. Data for each health outcome were summarized in tabular form and were discussed narratively.ResultsFinally, we included 372 studies in our scoping review, comprising 15 systematic reviews, 155 randomized controlled trials (RCTs), 23 non-randomized controlled trials, 57 cohort studies, 52 case-control studies, 28 cross sectional studies and 42 case series/case reports.In healthy subjects, appetite and short term food intake, risk of cancer, risk of diabetes, risk of dental caries, weight gain and risk of obesity are the most investigated health outcomes. Overall there is no conclusive evidence for beneficial and harmful effects on those outcomes. Numerous health outcomes including headaches, depression, behavioral and cognitive effects, neurological effects, risk of preterm delivery, cardiovascular effects or risk of chronic kidney disease were investigated in fewer studies and further research is needed. In subjects with diabetes and hypertension, the evidence regarding health outcomes of NNS use is also inconsistent.ConclusionsThis scoping review identifies the needs for future research to address the numerous evidence gaps related to health effects of NNSs use.It also specifies the research questions and areas where a systematic review with meta-analyses is required for the proper evaluation of health outcomes associated to regular NNSs consumption.

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“…OS and/or NNS are effective in providing analgesia in fullterm neonates undergoing heel-stick procedures, with the combined intervention being more effective compared with any single intervention. [25] Liu et al (2017) conducted a meta-analysis to evaluate the effect of combined OS and NNS for pain relief among newborns in NICU during painful procedures. They concluded that, the combination is effective not only for management but also for better prevention of procedure related pain among NICU newborns.…”

Section: Discussionmentioning

confidence: 99%

Role of sucrose, pacifier and their combination as pain reliever among preterm neonates during painful procedures

Yousef

Zaki

Ali

2019

JNEP

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Background/Objective: The role of sucrose and/or non-nutritive sucking (NNS) has been evaluated for relieving procedural pain in newborn infants with satisfactory results however there was a controversy regarding the synergestic effect of their combination.}Methods: This quasi-experimental study was conducted in the neonatal intensive care unit in Assiut University Children Hospital including 120 preterm neonates who were divided into 4 groups (20 neonates each). Control group received routine hospital care; sucrose group received oral sucrose solution (OS); pacifier group received pacifier; and last group received oral sucrose solution and pacifier during painful procedures. All were assessed regarding socio-demographic and clinical data in addition to application of Premature Infant Pain Profile (PIPP) scale to assess the levels of pain and mean pain scores pre and post-intervention.Results: The 4 groups were similar regarding soci-demographic and clinical data. The application of the OS and/or pacifier, led to significant improvement of the levels of pain and reduction of the mean score of pain among preterm neonates during painful procedures. In addition, combined pacifier and OS was superior to OS alone and comparable to pacifier alone regarding their effect on the reduction of pain level and mean score of pain.Conclusions: OS and pacifier are effective as pain reliever during painful procedures among preterm neonates. Combined OS and pacifier is superior to OS and pacifier alone.

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To evaluate and compare the efficacy of combined sucrose and non-nutritive sucking for analgesia in newborns undergoing minor painful procedure: a randomized controlled trial

Abstract: Sucrose and/or NNS are effective in providing analgesia in full-term neonates undergoing heel-stick procedures, with the combined intervention being more effective compared with any single intervention.

Cited by 35 publications

References 12 publications

Comparison of analgesic effect of 24% sucrose and breast milk in healthy infants less than 2 months of age

Comparison of analgesic effect of 24% sucrose and breast milk in healthy infants less than 2 months of age

Health outcomes of non-nutritive sweeteners: analysis of the research landscape

Role of sucrose, pacifier and their combination as pain reliever among preterm neonates during painful procedures

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