Stevens et al (2001) | Systematic review of 17 RCTs comparing sucrose to placebo | Systematic review (level 1a) | Behavioural (crying time, quality of suck), physiological (heart rate, respiratory rate, O2 saturation), multidimensional behavioural pain scores | Significant reduction in behavioural and physiological indicators of pain and in multidimensional pain scores, e.g. weighted mean difference for pain scores pooled across 3 studies at 30 sec after heel prick −1.64 (95% CI −2.47, −0.81) and at 60 sec −2.05 (95% CI −3.08, −1.02) | Patients studied ranged from 27 weeks to term babies. Doses used in studies were varied, ranging from 0.012 to 0.12g sucrose. Only one study looked at adverse effects. Ten studies were not completely double blinded as they used pacifiers as one of the experimental arms. Frequently studies did not report concealment of randomisation. Overall, however, all included studies were carefully planned and well designed |
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Abad et al (2001) | 51 term babies, <4 days old (55 venepunctures) randomised to 2ml 24% sucrose, 2ml spring water, 1g EMLA or sucrose and EMLA | RCT (level 1b) | Crying time, heart rate, O2 saturation, respiratory rate | Sucrose (compared with sterile water as placebo) significantly reduced crying time p=0.001 and heart rate p=0.04. (No absolute figures for crying time or heart rate given) | Study excluded by Cochrane review as 4 babies were included twice as they received 2 venepunctures during study period. The venepunctures were separated by at least 24 hours and the babies were randomised to another arm |
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Blass et al (1991) | 54 term babies, 28–54 hours old randomised to 2ml 12% sucrose or 2ml sterile water | RCT (level 1b) | Crying time during procedure and over 3 minutes following procedure | Sucrose with pacifier (compared with sterile water with pacifier) significantly reduced crying time during procedure (expressed as percentage of total procedure time) sucrose 42%, water 80%, p<0.01 | Study excluded by Cochrane as the number of neonates in each experimental group not stated |
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Blass et al (1997) | 72 neonates, birth weight 2976–3697g, 22–40 hours old randomised to 2ml of: sucrose, water, similac milk, Ross special formula, dilute fat, concentrated fat, fat/lactose, lactose or protein | RCT (level 1b) | Crying time during procedure and over 3 minutes following procedure | Sucrose (compared with sterile water) significantly reduced crying time during procedure (expressed as percentage of total procedure time) sucrose 47%, water 92%, p<0.015 | As there were 9 experimental groups in this study there were only 8 subjects in each group |