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American Academy of Pediatrics
Article

Sucrose and Warmth for Analgesia in Healthy Newborns: An RCT

Larry Gray, Elizabeth Garza, Danielle Zageris, Keri J. Heilman and Stephen W. Porges
Pediatrics March 2015, 135 (3) e607-e614; DOI: https://doi.org/10.1542/peds.2014-1073
Larry Gray
aDepartment of Pediatrics, University of Chicago, Chicago, Illinois;
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Elizabeth Garza
bPediatrics, Baylor College of Medicine, Houston, Texas;
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Danielle Zageris
cPhiladelphia College of Osteopathic Medicine, Philadelphia, Pennsylvania; and
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Keri J. Heilman
dDepartment of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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Stephen W. Porges
dDepartment of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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Abstract

BACKGROUND AND OBJECTIVE: Increasing data suggest that neonatal pain has long-term consequences. Nonpharmacologic techniques (sucrose taste, pacifier suckling, breastfeeding) are effective and now widely used to combat minor neonatal pain. This study examined the analgesic effect of sucrose combined with radiant warmth compared with the taste of sucrose alone during a painful procedure in healthy full-term newborns.

METHODS: A randomized, controlled trial included 29 healthy, full-term newborns born at the University of Chicago Hospital. Both groups of infants were given 1.0 mL of 25% sucrose solution 2 minutes before the vaccination, and 1 group additionally was given radiant warmth from an infant warmer before the vaccination. We assessed pain by comparing differences in cry, grimace, heart rate variability (ie, respiratory sinus arrhythmia), and heart rate between the groups.

RESULTS: The sucrose plus warmer group cried and grimaced for 50% less time after the vaccination than the sucrose alone group (P < .05, respectively). The sucrose plus warmer group had lower heart rate and heart rate variability (ie, respiratory sinus arrhythmia) responses compared with the sucrose alone group (P < .01), reflecting a greater ability to physiologically regulate in response to the painful vaccination.

CONCLUSIONS: The combination of sucrose and radiant warmth is an effective analgesic in newborns and reduces pain better than sucrose alone. The ready availability of this practical nonpharmacologic technique has the potential to reduce the burden of newborn pain.

  • infant
  • newborn
  • pain
  • analgesia
  • warmth
  • vaccination
  • crying
  • grimacing
  • heart rate
  • autonomic
  • sucrose
  • pacifier
  • Accepted November 25, 2014.
  • Copyright © 2015 by the American Academy of Pediatrics

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Pediatrics
Vol. 135, Issue 3
1 Mar 2015
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Sucrose and Warmth for Analgesia in Healthy Newborns: An RCT
Larry Gray, Elizabeth Garza, Danielle Zageris, Keri J. Heilman, Stephen W. Porges
Pediatrics Mar 2015, 135 (3) e607-e614; DOI: 10.1542/peds.2014-1073

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Sucrose and Warmth for Analgesia in Healthy Newborns: An RCT
Larry Gray, Elizabeth Garza, Danielle Zageris, Keri J. Heilman, Stephen W. Porges
Pediatrics Mar 2015, 135 (3) e607-e614; DOI: 10.1542/peds.2014-1073
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