Published online November 1, 2006
PEDIATRICS Vol. 118 Supplement November 2006, pp. S197-S202 (doi:10.1542/peds.2006-0913R)
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ARTICLE


Sucrose Analgesia: Identifying Potentially Better Practices

Linda Lefrak, RN, MSa, Kelly Burch, PharmDb, Rheta Caravantes, MSSCc, Kim Knoerlein, MS, ARNPd, Nancy DeNolf, NNPe, Jill Duncan, RN, MSN, MPHf, Frances Hampton, MSN, CNSg, Celeste Johnston, RN, DEdh, Debbie Lockey, RNi, Cassandra Martin-Walters RN, MSNj, Debra McLendon, RN, BSNi, Melinda Porter, RNC, CNS, NNPk, Cliff Richardson, NNPl, Cathy Robinson, RNm and Krystyna Toczylowski RN, MSNj

a Children’s Hospital Oakland, Oakland, California
b St John’s Mercy Medical Center, St Louis, Missouri
c Miami Valley Hospital, Dayton, Ohio
d Dartmouth-Hitchcock Medical Center, Dartmouth, New Hampshire
e DeVos Children’s Hospital, Grand Rapids, Michigan
f Inova Fairfax Hospital for Children, Falls Church, Virginia
g Wesley Medical Center, Wichita, Kansas
h James McGill Professor, McGill University, School of Nursing, Montreal, Quebec, Canada
i New Hanover Regional Medical Center, Wilmington, North Carolina
j Hackensack University Medical Center, Hackensack, New Jersey
k Lucile Packard Children’s Hospital, Palo Alto, California
l Woman’s Hospital, Baton Rouge, Louisiana
m Legacy Emanuel Children’s Hospital, Portland, Oregon

OBJECTIVE. The objectives of this study were to review the use of oral sucrose for procedural pain management in NICUs, develop potentially better practice guidelines that are based on the best current evidence, and provide ideas for the implementation of these potentially better practices.

METHODS. A collaboration of 12 centers of the Vermont Oxford Network worked together to review the strength of the evidence, clinical indications, dosage, administration, and contraindications and identify potential adverse effects for the use of sucrose analgesia as the basis of potentially better practices for sucrose analgesia guidelines. Several units implemented the guidelines.

RESULTS. Through reviews and inputs from all centers of the evidence, consensus was reached and guidelines that included indication, dosage per painful procedure, age-related dosage over 24 hours, method of delivery, and contraindications were developed.

CONCLUSIONS. Guidelines now are available from a consensus group, and suggestions for implementation of guidelines, based on implementation of other pain management strategies, were developed.

Key Words: preterm neonate • sucrose analgesia • best practice guidelines • guideline implementation

Abbreviations: NNS—nonnutritive sucking • NEC—necrotizing enterocolitis

Accepted Jul 18, 2006.


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