The analgesic effect of sucrose in full term infants: a randomised controlled trial

• Published in: BMJ 1995-06, Vol.310 (6993), p.1498-1500
• Main Authors: Haouari, Nora, Wood, Christopher, Griffiths, Gillian, Levene, Malcolm
• Format: Article
• Language: English
• Subjects: Administration, Oral; Age; Analgesia - methods; Analgesics; Babies; Blood; Blood Specimen Collection - adverse effects; Circumcision; Crying; Dose-Response Relationship, Drug; Double-Blind Method; Gestational age; Heart rate; Humans; Infant, Newborn; Infants; Newborns; Pain; Pain - etiology; Pain Management; Pain Measurement; Pediatrics; Punctures - adverse effects; Statistical median; Sucrose; Sucrose - administration & dosage; Sucrose - therapeutic use; Trajectory control
• ISSN: 0959-8138; 1468-5833; 1756-1833
• DOI: 10.1136/bmj.310.6993.1498

Abstract Objective: To evaluate the effects of different sucrose concentrations on measures of neonatal pain. Design: Randomised, double blind, placebo controlled trial of sterile water (control) or one of three solutions of sucrose—namely, 12.5%, 25%, and 50% wt/vol. Setting: Postnatal ward. Patients: 60 healthy infants of gestational age 37-42 weeks and postnatal age 1-6 days randomised to receive 2 ml of one of the four solutions on to the tongue two minutes before heel prick sampling for serum bilirubin concentrations. Main outcome measure: Duration of crying over the first three minutes after heel prick. Results: There was a significant reduction in overall crying time and heart rate after three minutes in the babies given 50% sucrose as compared with controls. This was maximal one minute after heel prick in the 50% sucrose group and became statistically significant in the 25% sucrose group at two minutes. There was a significant trend for a reduction in crying time with increasing concentrations of sucrose over the first three minutes. Conclusion: Concentrated sucrose solution seems to reduce crying and the autonomic effects of a painful procedure in healthy normal babies. Sucrose may be a useful and safe analgesic for minor procedures in neonates. Key messages Key messages Little is done to minimise the discomfort of these procedures Placing 2 ml of a 25% or 50% sucrose solution on the tongue before heel prick significantly reduces crying time There is a dose-response effect in the reduction of crying with increasing concentrations of sucrose Sucrose on the tongue may be a useful and safe form of analgesia in newborn infants