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Pain-relieving effect of sucrose in newborns during heel prick
1Department of Obstetrics and Gynaecology, Aalborg University Hospital, Aalborg, Denmark.
Insights
Sucrose effectively reduces pain and crying time in newborns during heel prick procedures. Comforting measures and low pre-procedure pain scores enhance sucrose
Area of Science:
- Neonatal care
- Pain management
- Pediatric research
Background:
- Heel prick procedures are common in newborns for diagnostic testing.
- Effective pain relief during these procedures is crucial for infant well-being.
- Previous research suggests sucrose may have analgesic properties in neonates.
Purpose of the Study:
- To evaluate sucrose as a pain reliever during newborn heel pricks.
- To investigate factors influencing pain response, including gender, age, and behavioral state.
- To assess the combined effect of sucrose and comforting interventions on pain.
Main Methods:
- A double-blind, randomized controlled trial involving 100 healthy, full-term infants.
- Infants received either 50% sucrose solution or sterile water before heel prick.
- Pain was assessed using crying time (CT) and Neonatal Infant Pain Scale (NIPS) scores.
Main Results:
- Sucrose significantly reduced both crying time and NIPS scores post-heel prick.
- No significant influence of gender, gestational age, postnatal age, or ponderal index on crying time was observed.
- Pre-procedure NIPS scores positively correlated with post-procedure crying time and pain scores.
Conclusions:
- Oral sucrose is a recommended and effective pain reliever for newborns undergoing heel pricks.
- Calming interventions and low pre-procedure pain scores can significantly reduce pain responses, additively with sucrose.
- This study supports a multimodal approach to neonatal pain management.
Abstract:
We assessed the effect of sucrose as a pain reliever in a population of newborns when cuddled and comforted during heel prick for diagnosis of phenylketonuria. In addition, the influences of gender, gestational age, postnatal age, ponderal index and behavioural state of the infant before the heel prick were studied, as judged by the neonatal infant pain scale (NIPS) score, on crying time (CT) and subsequent NIPS score. 100 healthy full-term infants were enrolled in this double-blind, randomized controlled trial. Before the heel prick, the newborns, when cuddled by the parent(s), were either given 2 ml 50% sucrose solution or 2 ml sterile water. The sessions were videotaped and analyzed for determination of CT and NIPS scores. The frequency distribution of CT showed a bimodal pattern in both the sucrose and the placebo groups. Sucrose significantly reduced CT and NIPS scores after the heel prick. No influence of gender, gestational age, postnatal age or ponderal index on CT was found. NIPS scores before the heel prick correlated significantly and positively with CT and subsequent NIPS scores in both the sucrose and the placebo groups. Intra-orally administered sucrose given before heel prick can be recommended as a useful pain reliever. Furthermore, the findings indicate that factors calming the newborn and creating low NIPS scores before the procedure can reduce the pain reaction equivalently and additively to sucrose administration.