Clinical Practice Update – PaediatricsOral sucrose for pain management in the paediatric emergency department; a review
Section snippets
Historical perspective
It has been almost 20 years since the first study demonstrating calming effects of sweet-tasting solutions in human infants was published. In a landmark study in 1989, Blass and colleagues demonstrated that crying infants given two 0.2 mL doses of 12% sucrose orally, rapidly became calm, with the calming effects persisting up to 5 min.9 In addition, Blass and colleagues were the first to publish results of blinded, randomised, controlled trials demonstrating the efficacy of small volumes of
Sucrose analgesia beyond the newborn period
Studies of sucrose-induced analgesia beyond the neonatal period have primarily been conducted during scheduled childhood immunisation in infants ranging from 2 to 18 months of age.18, 19, 20, 21, 22, 23 The majority of these studies were randomised, controlled trials evaluating the efficacy of either oral sucrose or glucose during a single episode of routine vaccination, which may have included either a single injection, or multiple injections. Two studies however, were longitudinal randomised,
Conclusion
Sucrose is a short-acting, mild analgesic, which may be a useful strategy in the ED for management of minor painful procedures in infants up to 18 months of age. Pain needs to be carefully evaluated and both appropriate comfort measures and adjunct analgesia needs to be considered, especially if the procedure becomes prolonged. As some of the evidence of sucrose effectiveness in infants beyond the neonatal period is conflicting, further studies are warranted to determine the degree of
Competing Interests
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Funding Interests
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Cited by (11)
Comparison of the analgesic effect of oral sucrose and/or music in preterm neonates: A double-blind randomized clinical trial
2020, Complementary Therapies in MedicineCitation Excerpt :Different non-pharmacological methods have been reported to exert an analgesic effect on preterm neonates during painful procedures.2 One of the widely recommended pain management methods is using oral sucrose.2,8–11 In an integrated review, oral sucrose has been introduced as an effective, safe, and immediate-acting analgesic that can decrease the behavioral pain responses in infants during painful stimuli.12
Promoting the use of sucrose as analgesia for procedural pain management in neonates: A review of the current literature
2012, Journal of Neonatal NursingCitation Excerpt :Due to the opoid receptors on the tongue, the effect is only achieved by oral administration and not by nasogastric instillation straight into the stomach. Since the effect is short acting, it should be used for procedural pain management for the many tasks neonates are subjected to on a frequent basis within the neonatal unit; namely heel pricks, cannulation and venepuncture, naso/orogastric tube insertion, intramuscular injection, urinary catheterization, eye examinations, suturing, lumbar puncture, suction, immunizations and dressing changes (Thompson et al., 2011; Harrison et al., 2008a). The effect of sucrose is also said to be enhanced by breast milk (Shah et al., 2007) and using a pacifier is proposed to augment the benefits due probably to the effects of non-nutritive sucking as a consoling measure (Harrison et al., 2009).
Sweet tasting solutions for reduction of needle-related procedural pain in children aged one to 16 years
2015, Cochrane Database of Systematic ReviewsOral sucrose administration to reduce pain response during immunization in 16–19-month infants: a randomized, placebo-controlled trial
2014, European Journal of PediatricsComfort measures: A concept analysis
2013, Research and Theory for Nursing PracticeThe Cochrane Library and procedural pain in children: An overview of reviews
2012, Evidence-Based Child Health