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Effectiveness of Sucrose Used Routinely for Pain Relief and Neonatal Clinical Risk in Preterm Infants: A
Beatriz O Valeri1, Cláudia M Gaspardo1, Francisco E Martinez2
1Departments of Neurosciences and Behavior.
Insights
Routine sucrose effectively reduces pain in preterm infants (PI) regardless of their clinical risk. This pain relief strategy improves biobehavioral regulation during painful procedures in the neonatal intensive care unit.
Area of Science:
- Neonatal care
- Pain management
- Biobehavioral research
Background:
- Preterm infants (PI) in neonatal intensive care units experience significant pain and distress.
- The interaction between pain relief strategies and infant clinical health status is not well understood.
- This study investigates the effects of sucrose intervention and neonatal clinical risk (NCR) on pain responses in PI.
Purpose of the Study:
- To examine the main and interactive effects of sucrose intervention and NCR on biobehavioral pain reactivity and recovery in preterm infants.
- To assess how pain relief strategies influence pain responses in relation to illness severity.
- To evaluate the efficacy of routine sucrose for pain management in neonates.
Main Methods:
- 104 very low birth weight preterm infants were categorized into low and high neonatal clinical risk (NCR) groups.
- Infants received either 25% sucrose solution or standard care before painful procedures.
- Biobehavioral pain responses were assessed using facial coding, sleep-wake state, crying time, and heart rate across five phases.
Main Results:
- Sucrose significantly reduced facial pain responses and crying time, independent of NCR.
- All infants showed heightened arousal during the painful puncture and decreased responses during recovery.
- No significant effects of sucrose or NCR were observed on physiological reactivity (heart rate), with all infants showing recovery to baseline.
Conclusions:
- Routine sucrose intervention is effective in reducing pain intensity during acute painful procedures for preterm infants.
- Sucrose enhances biobehavioral regulation in preterm infants, irrespective of their neonatal clinical risk level.
- Pain relief strategies can be tailored based on clinical risk to improve outcomes for preterm infants.
Background:
Preterm infants (PI) requiring the neonatal intensive care unit are exposed to early repetitive pain/distress. Little is known about how pain relief strategies interact with infants' clinical health status, such as severity of illness with pain responses. This study aimed to examine main and interactive effects of routine sucrose intervention and neonatal clinical risk (NCR) on biobehavioral pain reactivity-recovery in PI during painful blood collection procedures.
Methods:
Very low birth weight PI (<1500 g; n=104) were assigned to low and high clinical risk groups, according to the Clinical Risk Index for Babies. Sucrose group (n=52) received sucrose solution (25%; 0.5 mL/kg) 2 minutes before the procedures and control group received standard care. Biobehavioral pain reactivity-recovery was assessed according to the Neonatal Facial Coding System, sleep-wake state scale, crying time, and heart rate at 5 phases (baseline, antisepsis, puncture (P), recovery-dressing, and recovery-resting [R]). Repeated measure ANOVA with mixed-design was performed considering pain assessment phases, intervention group, and NCR.
Results:
Independent of NCR, sucrose presented main effect in decreasing neonates' facial activity pain responses and crying time, during P and R. Independent of NCR level or routine sucrose intervention, all neonates displayed activated state in P and decreased biobehavioral responses in R phase. Although no sucrose or NCR effects were observed on physiological reactivity, all neonates exhibited physiological recovery 10 minutes after P, reaching the same heart rate patterns as the baseline.
Conclusions:
Independent of NCR level, sucrose intervention for pain relief during acute painful procedures was effective to reduce pain intensity and increase biobehavioral regulation.
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