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Randomized Controlled Trial
. 2015 Mar;135(3):e607-14.
doi: 10.1542/peds.2014-1073. Epub 2015 Feb 16.

Sucrose and warmth for analgesia in healthy newborns: an RCT

Larry Gray  1 , Elizabeth Garza  2 , Danielle Zageris  3 , Keri J Heilman  4 , Stephen W Porges  4
Affiliations
Randomized Controlled Trial

Sucrose and warmth for analgesia in healthy newborns: an RCT

Larry Gray et al. Pediatrics. 2015 Mar.

Abstract

Background and objective: Increasing data suggest that neonatal pain has long-term consequences. Nonpharmacologic techniques (sucrose taste, pacifier suckling, breastfeeding) are effective and now widely used to combat minor neonatal pain. This study examined the analgesic effect of sucrose combined with radiant warmth compared with the taste of sucrose alone during a painful procedure in healthy full-term newborns.

Methods: A randomized, controlled trial included 29 healthy, full-term newborns born at the University of Chicago Hospital. Both groups of infants were given 1.0 mL of 25% sucrose solution 2 minutes before the vaccination, and 1 group additionally was given radiant warmth from an infant warmer before the vaccination. We assessed pain by comparing differences in cry, grimace, heart rate variability (ie, respiratory sinus arrhythmia), and heart rate between the groups.

Results: The sucrose plus warmer group cried and grimaced for 50% less time after the vaccination than the sucrose alone group (P < .05, respectively). The sucrose plus warmer group had lower heart rate and heart rate variability (ie, respiratory sinus arrhythmia) responses compared with the sucrose alone group (P < .01), reflecting a greater ability to physiologically regulate in response to the painful vaccination.

Conclusions: The combination of sucrose and radiant warmth is an effective analgesic in newborns and reduces pain better than sucrose alone. The ready availability of this practical nonpharmacologic technique has the potential to reduce the burden of newborn pain.

Keywords: analgesia; autonomic; crying; grimacing; heart rate; infant; newborn; pacifier; pain; sucrose; vaccination; warmth.

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Figures

FIGURE 1
FIGURE 1
Cry and grimace durations. Durations were coded after completion of the vaccination. Infants in the sucrose plus warmer group cried for significantly less time (P < .05, Kruskal–Wallis test) and grimaced significantly less than infants in the sucrose alone group (P < .05, Kruskal–Wallis test).
FIGURE 2
FIGURE 2
Heart rate during protocol. The sucrose plus warmer group had dampened heart rate acceleration to the vaccination, F(1, 25) = 6.1, P < .02.
FIGURE 3
FIGURE 3
RSA. The sucrose plus warmer group had a dampened suppression of RSA in response to the vaccination, F(2, 50) = 4.12, P < .02.
See this image and copyright information in PMC

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References

    1. Anand KJS. Consensus statement for the prevention and management of pain in the newborn. Arch Pediatr Adolesc Med. 2001;155(2):173–180 - PubMed
    1. Asmerom Y, Slater L, Boskovic DS, et al. Oral sucrose for heel lance increases adenosine triphosphate use and oxidative stress in preterm neonates. J Pediatr. 2013;163(1):29–35.e21 - PMC - PubMed
    1. Harrison D, Beggs S, Stevens B. Sucrose for procedural pain management in infants. Pediatrics. 2012;130(5):918–925 - PubMed
    1. Sweet S, McGrath P. Progress in pain research and management. In: Finley G, McGrath P, eds. Physiological measures of pain. Vol. 10 Seattle, WA: IASP Press; 1998:59–81
    1. Taddio A, Goldbach M, Ipp M, Stevens B, Koren G. Effect of neonatal circumcision on pain responses during vaccination in boys. Lancet. 1995;345(8945):291–292 - PubMed

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