Published online February 1, 2008
PEDIATRICS Vol. 121 No. 2 February 2008, pp. e327-e334 (doi:10.1542/peds.2006-3719)
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ARTICLE

Analgesic Properties of Oral Sucrose During Routine Immunizations at 2 and 4 Months of Age

Linda A. Hatfield, PhD, CNNPa, Maryellen E. Gusic, MDb, Anne-Marie Dyer, MSc and Rosemary C. Polomano, PhD, RN, FAANd

a Pennsylvania State University School of Nursing, College of Health and Human Development, University Park, Pennsylvania
b Division of General Pediatrics, Pennsylvania State University College of Medicine
c Division of Biostatistics, Public Health Sciences, Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania
d Biobehavioral Research Center, University of Pennsylvania School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania

OBJECTIVE. The purpose of this work was to evaluate the analgesic properties of oral sucrose during routine immunizations in infants at 2 and 4 months of age.

PATIENTS AND METHODS. A prospective, randomized, placebo-controlled clinical trial was conducted at a pediatric ambulatory care clinic. One-hundred healthy term infants scheduled to receive routine immunizations were recruited, randomly stratified into 2- or 4-month study groups, and further randomly assigned to receive 24% oral sucrose and pacifier or the sterile water control solution. The study preparations were administered 2 minutes before the combined diphtheria-tetanus-acellular pertussis, inactivated polio vaccine, and hepatitis B vaccine. Haemophilus influenzae type b vaccine was administered 3 minutes after the combined injection, followed by the pneumococcal conjugate vaccine, 2 minutes after the H influenzae type b injection. The University of Wisconsin Children's Hospital Pain Scale measured serial acute pain responses for the treatment and control groups at baseline and 2, 5, 7, and 9 minutes after solution administration. Repeated-measures analysis of variance examined between-group differences and within-subject variability of treatment effect on overall pain scores.

RESULTS. Two- and 4-month-old infants receiving oral sucrose (n = 38) displayed reductions in pain scores 2 minutes after solution administration compared with 2- and 4-month-old infants in the placebo group (n = 45). Between-group comparisons for the oral sucrose and placebo groups showed lower pain responses at 5, 7, and 9 minutes after solution administration. The oral sucrose and placebo groups demonstrated their highest mean pain score at 7 minutes, with a mean pain score of 3.8 and 4.8, respectively. At 9 minutes, the placebo group had a mean pain score of 2.91 whereas the mean pain score for the oral sucrose group returned to near baseline, reflecting a 78.5% difference in mean pain score (oral sucrose – placebo) relative to the placebo mean.

CONCLUSIONS. Oral sucrose is an effective, easy-to-administer, short-acting analgesic for use during routine immunizations.

Key Words: immunizations • infant • pain • sucrose

Abbreviations: RCT—randomized, controlled trial • NNS—nonnutritive sucking • UWCH—University of Wisconsin Children's Hospital • CI—confidence interval • NNT—number needed to treat

Accepted Jul 19, 2007.




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