Oral 24% sucrose associated with nonnutritive sucking for pain control in healthy term newborns receiving venipuncture beyond the first week of life

Abstract

Objective: To test the hypothesis that oral administration of 24% sucrose associated with ­nonnutritive sucking in healthy newborns receiving venipuncture beyond the first week of life controls pain and pain-related variation in heart rate (HR) and noninvasive oxygen saturation (SpO 2 ). Methods: A total of 66 term newborns were enrolled between February and September 2017 in the Neonatology Department of AORN Santobono-Pausilipon, Naples. They were randomly assigned to receive oral 1 mL 24% sucrose (treated group [TG], n=33; gestational age 38.53±1.49 weeks; body weight 3,035±55 g; age 22.40±6.82 weeks) or oral 1 mL 10% glucose (control group [CG], n=33; gestational age 38.91±1.45 weeks; body weight 3,203±65 g; age 23.36±7.02 weeks) 1 minute before and during venipuncture. Evaluations were carried out between 8 and 9 am in all newborns. The Neonatal Infant Pain Scale (NIPS) was used to assess pain in newborns. Outcome measurements (HR, SpO 2 ) were obtained before (T0), during (T1), and 1 minute after (T2) venipuncture using a Nellcor bedside SpO 2 patient-monitoring system. NIPS scores were recorded throughout the procedure. Statistical analysis was performed using SPSS version 20.0. Changes in HR and SpO 2 were assessed by mixed ANOVA for repeated measures. NIPS scores were evaluated by Mann–Whitney U test. Results: There were no statistically significant differences in HR or SpO 2 between TG and CG at T0. HR was significantly lower in TG than CG at both T1 and T2 ( P <0.05), whereas SpO 2 was significantly higher in TG than CG at both T1 and T2 ( P <0.05). NIPS scores were significantly lower in TG (median 0) than CG (median 6) during the entire procedure ( P <0.05). Conclusion: Oral administration of 24% sucrose associated with nonnutritive sucking prior to and during a painful procedure has a strong impact on pain response in term newborns, reducing NIPS scores and influencing pain-associated variations in HR and SpO 2 . Complete analgesia during painful procedures in term newborns might prevent pain reactivity and its behavioral and neurodevelopmental consequences. Replication of this study is needed before widespread application of findings. Keywords: oral sucrose, heart rate, neonatal pain A Letter to the Editor has been published for this article A Response to Letter has been published for this article