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Published on: January 16, 2014
The cold pressor test in children: methodological aspects and the analgesic effect of intraoral sucrose
Anton Miller1, Ronald G Barr, Simon N Young
1Department of Pediatrics, McGill University, Montreal, Quebec H3H 1P3 Canada Department of Psychiatry, McGill University, Montreal, Quebec H3H 1P3 Canada School of Dietetics and Human Nutrition, McGill University, Montreal, Quebec H3H 1P3 Canada Departments of McGill University-Montreal Children's Hospital Research Institute, Montreal, Quebec H3H 1P3 Canada.
Insights
Intraoral sucrose may offer pain relief for children. Studies show sucrose significantly prolonged pain threshold times in children during a cold pressor test, suggesting analgesic-like effects.
Area of Science:
- Pediatric Pain Management
- Neuroscience of Pain
Background:
- Intraoral sucrose has demonstrated analgesic effects in newborns and rat pups.
- Assessing pain perception in pre-pubertal children requires ethical and viable laboratory methods.
Purpose of the Study:
- To investigate the analgesic-like effects of intraoral sucrose in pre-pubertal children.
- To evaluate the cold pressor test (CPT) as a laboratory pain assessment tool for this age group.
Main Methods:
- 42 children aged 8-11 participated.
- Participants underwent the cold pressor test (CPT) at 10°C on two consecutive days.
- They held either 24% sucrose or water in their mouths during the test, with pain threshold, tolerance, and VAS ratings measured.
Main Results:
- Sucrose significantly increased pain threshold times by 35% compared to water.
- No significant effects of sucrose were found on pain tolerance or intensity ratings (VAS).
- Limitations in data validity and participant adherence were noted, particularly in younger children.
Conclusions:
- Intraoral sucrose exhibits analgesic properties in pre-pubertal children, similar to findings in neonates.
- The cold pressor test (CPT) can be utilized for pain research in children, though methodological considerations are important.
Abstract:
To determine whether intraoral sucrose has analgesic-like effects in pre-pubertal children and to explore the utility of an ethical and viable laboratory test of nociceptive stimulation in this age group, 8-11-year-olds (n = 42) underwent the cold pressor test (CPT) at 10 degrees C on each of 2 successive days, while holding either 24% sucrose or water in their months. Outcome measures used were threshold (time at which the arm first started to hurt), tolerance (when children removed their arms because they could not stand it any more) and visual analogue scale (VAS) ratings of the intensity of sensation. To ensure validity of the data obtained in this age group, some responses were rejected according to established decision rules and blind to group assignment. Each measure produced interesting data but also had limitations. Threshold data that did not meet validity criteria occurred more frequently with younger children. Tolerance data was not available for a significant proportion (57%) of children, since they left their arms in the water for the maximum time allowed (4 min). This occurred more frequently on the second day of testing and with younger children. Inability to perform adequately on the VAS also occurred, but was not related to age. Holding sucrose in the mouth was associated with a significant 35% prolongation of the children's threshold times relative to water, but there was no detectable effect on tolerance and intensity ratings. It is concluded that the analgesic properties of intraoral sucrose, seen previously in human newborns and rat pups, may also be present in pre-pubertal children.(ABSTRACT TRUNCATED AT 250 WORDS)
