Related Experiment Video
Updated: Jan 3, 2026
A General Method for Evaluating Incubation of Sucrose Craving in Rats
Published on: November 4, 2011
Repeating a dose of sucrose for heel prick procedure in preterms is not effective in reducing pain: a randomised
Paola Lago1,2, Maria Elena Cavicchiolo3, Teresa Mion1
1Neonatal Intensive Care Unit, Department of Woman and Child Health, University of Padua, Via Giustiniani 3, 35128, Padua, Italy.
Insights
Doubling the oral sucrose dose for newborns during heel prick procedures does not reduce pain perception. This study found no significant difference in pain scores between standard and double doses, suggesting the standard dose is sufficient.
Area of Science:
- Neonatal care
- Pain management
- Clinical trials
Background:
- Oral sucrose is a standard recommendation for procedural pain relief in newborns.
- Evidence regarding the efficacy of multiple sucrose doses versus a single standard dose is limited.
- The Premature Infant Pain Profile (PIPP) scale is the gold standard for assessing pain in preterm infants but is challenging for routine clinical use.
Purpose of the Study:
- To compare the efficacy of a single standard dose versus a double dose of oral sucrose for pain management during heel prick procedures in preterm infants.
- To evaluate the concordance between the PIPP scale and other more clinically feasible pain assessment tools.
Main Methods:
- A single-centre, double-blind, randomized controlled trial was conducted.
- Preterm infants undergoing heel prick were randomized to receive either a standard or a double dose of 24% oral sucrose.
- Pain was assessed using the PIPP scale at multiple time points post-procedure.
Main Results:
- No statistically significant difference in pain scores, as measured by the PIPP scale, was observed between the standard and double sucrose dose groups.
- Pain perception remained similar across baseline, 30 seconds, 60 seconds, and 2 minutes post-heel prick in both groups.
- No correlation was found between PIPP scores and other pain scales evaluated for clinical feasibility.
Conclusions:
- Doubling the dose of oral sucrose is not recommended for managing pain during heel prick procedures in preterm infants.
- Repeating sucrose doses does not enhance pain reduction during the recovery phase of skin-breaking procedures.
- Easier-to-use pain scales are not directly comparable to the PIPP scale for evaluating procedural pain in preterm neonates.
Abstract:
Oral sucrose is included in almost all recommendations for treatment of pain in newborns, but evidence if multiple doses might be more effective than a single standard dose is lacking. We designed a single-centre, double-blind, randomised, controlled trial. We enrolled preterm infants needing the heel prick procedure. Each enrolled infant was randomised to receive a single standard dose of sucrose 2 min before or a double dose of sucrose 2 min before, and 30 s after heel prick. Primary outcome was the efficacy of the two interventions tested by the premature infant pain profile-PIPP scale obtained at 30 s, 60 s, and 120 s after heel prick. Secondary outcome was the evaluation of the concordance between the PIPP scale and other pain scores more feasible in clinical practice. Seventy-two infants were randomised. No difference in pain perception as measured by the PIPP scale was found between the groups: median PIPP values 4.0(IQR 3.0-4.0) vs 3.0(IQR 3.0-4.0) at baseline; 6.0(IQR 5.0-10.0) vs 6.0(IQR 4.0-8.5) at 30 s; 6.0(IQR 4.0-7.0) vs 5.0(IQR 4.0-8.5) at 60 s and 5.0(IQR 4.0-7.0) vs 5.0(IQR 4.0-7.5) at 2 min, in the experimental and standard treatment groups, respectively (p = 0.9020). There was no correlation between PIPP scores and other pain scales.Conclusion: We do not recommend doubling the dose during heel prick.What is Known:• Oral sucrose is included in almost all international position papers and recommendations for the treatment of mild to moderate pain in newborns, associated with non-nutritive sucking and facilitated tucking• Premature infant pain profile (PIPP) scale is the gold standard for evaluation of pain in preterms but it is difficult to use in clinical practiceWhat is New:• Repeating a dose of 24% sucrose is not effective in reducing pain during the recovery phase of a skin breaking procedure• Other pain scales, easier to use in clinical practice, are not comparable with PIPP for the evaluation of procedural pain in preterms.
More Related Videos
06:29Electrophysiological Measurement of Noxious-evoked Brain Activity in Neonates Using a Flat-tip Probe Coupled to Electroencephalography
Published on: November 29, 2017
07:33Sucrose Preference and Novelty-Induced Hypophagia Tests in Rats using an Automated Food Intake Monitoring System
Published on: May 8, 2020