Oral Sucrose and Facilitated Tucking for Repeated Pain Relief in Preterms: A Randomized Controlled Trial

• Published in: Pediatrics (Evanston) 2012-02, Vol.129 (2), p.299-308
• Main Authors: CIGNACCO, Eva L, SELLAM, Gila, STOFFEL, Lillian, GERULL, Roland, NELLE, Mathias, ANAND, Kanwaljeet J. S, ENGBERG, Sandra
• Format: Article
• Language: English
• Subjects: Administration, Oral; Analgesia; Babies; Biological and medical sciences; Care and treatment; Clinical trials; Combined Modality Therapy - nursing; Comparative analysis; Dosage and administration; Drug therapy; Facilitated Tucking - methods; Facilitated Tucking - psychology; Feasibility Studies; General aspects; Gestational Age; Health aspects; Hospitals, University; Humans; Infant, Newborn; Infant, Premature, Diseases - nursing; Infant, Premature, Diseases - psychology; Intensive Care Units, Neonatal; Intervention; Medical sciences; Methods; Pain; Pain in children; Pain management; Pain Management - nursing; Pain Management - psychology; Pain Measurement - nursing; Pediatric pain; Pediatrics; Sucrose; Sucrose - administration & dosage
• ISSN: 0031-4005; 1098-4275
• DOI: 10.1542/peds.2011-1879

To test the comparative effectiveness of 2 nonpharmacologic pain-relieving interventions administered alone or in combination across time for repeated heel sticks in preterm infants. A multicenter randomized controlled trial in 3 NICUs in Switzerland compared the effectiveness of oral sucrose, facilitated tucking (FT), and a combination of both interventions in preterm infants between 24 and 32 weeks of gestation. Data were collected during the first 14 days of their NICU stay. Three phases (baseline, heel stick, recovery) of 5 heel stick procedures were videotaped for each infant. Four independent experienced nurses blinded to the heel stick phase rated 1055 video sequences presented in random order by using the Bernese Pain Scale for Neonates, a validated pain tool. Seventy-one infants were included in the study. Interrater reliability was high for the total Bernese Pain Scale for Neonates score (Cronbach's α: 0.90-0.95). FT alone was significantly less effective in relieving repeated procedural pain (P < .002) than sucrose (0.2 mL/kg). FT in combination with sucrose seemed to have added value in the recovery phase with lower pain scores (P = .003) compared with both the single-treatment groups. There were no significant differences in pain responses across gestational ages. Sucrose with and without FT had pain-relieving effects even in preterm infants of