Sucrose May Be Helpful for Pediatric Analgesia (Pediatrics)
March 3, 2009
Laurie Barclay, MD
Information from Industry
Sucrose may be helpful for pediatric analgesia, according to the results of a double-blind, randomized controlled trial reported in the March issue of Pediatrics. ‘Sucrose has analgesic and calming effects in newborns,’ write Anna Taddio, PhD, from the University of Toronto in Toronto, Ontario, Canada, and colleagues. ‘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.’
Healthy neonates were stratified into 2 groups (normal infants and infants of diabetic mothers) and randomly assigned to receive sucrose or placebo (water) before all postpartum needle procedures. The Premature Infant Pain Profile (PIPP), a validated multidimensional measure, was used to assess pain response during a diaper change performed after venipuncture for the newborn screening test.
Between September 15, 2003, and July 27, 2004, a total of 412 parents were asked to have their infants participate in the study, and 263 consented. Of these, 23 infants were not randomly selected, and 120 were in each group, with an equal number in each infant stratum. Of the 240 randomly selected participants, 186 (78%) completed the study.
The 2 groups had similar birth characteristics. Infants receiving sucrose had lower pain scores during diaper change vs infants receiving placebo. The relative risk of having pain (defined as a PIPP score of ≥ 6) was 0.64 with sucrose vs placebo. ‘This study demonstrates that when used to manage pain, sucrose reduces the pain response to a subsequent routine caregiving procedure,’ the study authors write. ‘Therefore, the benefits of sucrose analgesia extend beyond the painful event to other aversive and potentially painful procedures.’
Limitations of this study include assessment of only the first 20 seconds of the infants’ response. ‘Based on these results, sucrose may be recommended for postprocedural caregiving procedures that follow painful procedures,’ the study authors conclude. ‘The results also further support the use of sucrose to manage procedural pain in newborn infants.’
The Canadian Institutes of Health funded this study. Respironics Inc (Monroeville, Pennsylvania) provided study supplies (sucrose and placebo). Dr. Taddio was supported by a New Investigator Award by the Canadian Institutes of Health Research. Coauthor Joel Katz, PhD, was supported by a Canada Research Chair in Health Psychology at York University. Coauthor Vibhuti Shah, MD, has disclosed no relevant financial relationships.
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