A Sweet Way to Relieve Neonatal Pain

This is sweet!
Sucrose has analgesic properties in neonates.  Crying time and pain scores are reduced.  This was a meta-analysis of 168 studies...whoa - I'll bet that took a minute!  Of these, 148 had placebo or no treatment arms.  The point of these authors is that "no treatment" is no longer an ethical option when conducting such trials.  But for us, it's a good reminder to use this risk-free method to make procedures a little less painful for our smallest patients.  Sucrose on a pacifier is like magic.  Try it for your next neonatal procedure.

Spoon Feed
Sucrose, or sweet taste analgesia, works well in neonates.  Use it.  And if you do neonatal research, this paper makes a strong argument that it is no longer ethical to provide no treatment to the control arm.


Abstract

Pediatrics. 2016 Dec 16. pii: e20160955. [Epub ahead of print]

Sweet Solutions to Reduce Procedural Pain in Neonates: A Meta-analysis.

Harrison D1,2, Larocque C3,2, Bueno M4, Stokes Y3,2, Turner L5, Hutton B6, Stevens B7,8.

Author information:

1Children's Hospital of Eastern Ontario (CHEO) Research Institute, Ottawa, Ontario, Canada; dharrison@cheo.on.ca.

2School of Nursing, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada.

3Children's Hospital of Eastern Ontario (CHEO) Research Institute, Ottawa, Ontario, Canada.

4Departamento Enfermagem Materno-Infantil e Psiquiátrica (ENP), University of São Paulo, São Paulo, Brazil.

5Institute of Health Economics, Edmonton, Alberta, Canada.

6Ottawa Hospital Research Institute (OHRI), Ottawa, Ontario, Canada.

7The Hospital for Sick Children, Toronto, Ontario, Canada; and.

8Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada.

Abstract

CONTEXT:

Abundant evidence of sweet taste analgesia in neonates exists, yet placebo-controlled trials continue to be conducted.

OBJECTIVE:

To review all trials evaluating sweet solutions for analgesia in neonates and to conduct cumulative meta-analyses (CMAs) on behavioral pain outcomes.

DATA SOURCES:

(1) Data from 2 systematic reviews of sweet solutions for newborns; (2) searches ending 2015 of CINAHL, Medline, Embase, and psychINFO.

DATA EXTRACTION AND ANALYSIS:

Two authors screened studies for inclusion, conducted risk-of-bias ratings, and extracted behavioral outcome data for CMAs. CMA was performed using random effects meta-analysis.

RESULTS:

One hundred and sixty-eight studies were included; 148 (88%) included placebo/no-treatment arms. CMA for crying time included 29 trials (1175 infants). From the fifth trial in 2002, there was a statistically significant reduction in mean cry time for sweet solutions compared with placebo (-27 seconds, 95% confidence interval [CI] -51 to -4). By the final trial, CMA was -23 seconds in favor of sweet solutions (95% CI -29 to -18). CMA for pain scores included 50 trials (3341 infants). Results were in favor of sweet solutions from the second trial (0.5, 95% CI -1 to -0.1). Final results showed a standardized mean difference of -0.9 (95% CI -1.1 to -0.7).

LIMITATIONS:

We were unable to use or obtain data from many studies to include in the CMA.

CONCLUSIONS:

Evidence of sweet taste analgesia in neonates has existed since the first published trials, yet placebo/no-treatment, controlled trials have continued to be conducted. Future neonatal pain studies need to select more ethically responsible control groups.

Copyright © 2017 by the American Academy of Pediatrics.

PMID: 27986905 [PubMed - as supplied by publisher]