BMJ 1995;310:1498-1500 (10 June)

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The analgesic effect of sucrose in full term infants: a randomised controlled trial

Nora Haouari, visiting clinical fellow,a Christopher Wood, lecturer,a Gillian Griffiths, research nurse,a Malcolm Levene, professor of paediatrics a

a University Division of Paediatrics and Child Health, D Floor, Clarendon Wing, Leeds General Infirmary, Leeds LS2 9NS

Correspondence to: Professor Levene.

Abstract

Objective: To evaluate the effects of different sucrose concentrations on measures of neonatal pain.
Design: Randomised, double blind, placebo controlled trial of sterile water (control) or one of three solutions of sucrose--namely, 12.5%, 25%, and 50% wt/vol.
Setting: Postnatal ward.
Patients: 60 healthy infants of gestational age 37-42 weeks and postnatal age 1-6 days randomised to receive 2 ml of one of the four solutions on to the tongue two minutes before heel prick sampling for serum bilirubin concentrations.
Main outcome measure: Duration of crying over the first three minutes after heel prick.
Results: There was a significant reduction in overall crying time and heart rate after three minutes in the babies given 50% sucrose as compared with controls. This was maximal one minute after heel prick in the 50% sucrose group and became statistically significant in the 25% sucrose group at two minutes. There was a significant trend for a reduction in crying time with increasing concentrations of sucrose over the first three minutes.
Conclusion: Concentrated sucrose solution seems to reduce crying and the autonomic effects of a painful procedure in healthy normal babies. Sucrose may be a useful and safe analgesic for minor procedures in neonates.

Key messages

  • Key messages

  • Little is done to minimise the discomfort of these procedures

  • Placing 2 ml of a 25% or 50% sucrose solution on the tongue before heel prick significantly reduces crying time

  • There is a dose-response effect in the reduction of crying with increasing concentrations of sucrose

  • Sucrose on the tongue may be a useful and safe form of analgesia in newborn infants


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