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Published online March 2, 2009
PEDIATRICS Vol. 123 No. 3 March 2009, pp. e425-e429 (doi:10.1542/peds.2008-3028)
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ARTICLE

Reduced Infant Response to a Routine Care Procedure After Sucrose Analgesia

Anna Taddio, PhDa,b, Vibhuti Shah, MDc,d, Joel Katz, PhDe,f

a Leslie Dan Faculty of Pharmacy
d Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
b Child Health Evaluative Sciences, Hospital for Sick Children, Toronto, Ontario, Canada
c Department of Pediatrics
f Anaesthesia, Mount Sinai Hospital, Toronto, Ontario, Canada
e Department of Psychology, York University, Toronto, Ontario, Canada

OBJECTIVES. Sucrose has analgesic and calming effects in newborns. To date, it is not known whether the beneficial effects extend to caregiving procedures that are performed after painful procedures. Our objective was to determine the effect of sucrose analgesia for procedural pain on infant pain responses during a subsequent caregiving procedure.

PATIENTS AND METHODS. We conducted a double-blind, randomized, controlled trial. Healthy neonates within 2 strata (normal infants and infants of diabetic mothers) were randomly assigned to a sucrose or placebo water group before all needle procedures after birth. Pain response during a diaper change performed after venipuncture for the newborn screening test was determined by using a validated multidimensional measure, the Premature Infant Pain Profile.

RESULTS. The study was conducted between September 15, 2003, and July 27, 2004. Altogether, 412 parents were approached; 263 consented. Twenty-three infants were not assigned, leaving 240 for participation (n = 120 per group), with an equal number in each infant strata. Of those, 186 (78%) completed the study. There were no significant differences in birth characteristics between groups. During diaper change, sucrose-treated infants had lower pain scores than placebo-treated infants. The relative risk of having pain, defined as a Premature Infant Pain Profile score of ≥6, was 0.64 with sucrose compared with placebo.

CONCLUSIONS. This study demonstrates that when used to manage pain, sucrose reduces the pain response to a subsequent routine caregiving procedure. Therefore, the benefits of sucrose analgesia extend beyond the painful event to other aversive and potentially painful procedures.

Key Words: sucrose • pain • infant • newborn • caregiving procedure • diaper change • randomized • controlled trial

Abbreviations: DMs—diabetic mothers • PIPP—Premature Infant Pain Profile • CI—confidence interval • ANCOVA—analysis of covariance

Accepted Nov 12, 2008.


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