Sucrose and warmth for analgesia in healthy newborns: an RCT

Increasing data suggest that neonatal pain has long-term consequences. Nonpharmacologic techniques (sucrose taste, pacifier suckling, breastfeeding) are effective and now widely used to combat minor neonatal pain. This study examined the analgesic effect of sucrose combined with radiant warmth compa...

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Bibliographic Details
Published in:Pediatrics (Evanston) 2015-03, Vol.135 (3), p.e607-e614
Main Authors: Gray, Larry, Garza, Elizabeth, Zageris, Danielle, Heilman, Keri J, Porges, Stephen W
Format: Article
Language:English
Subjects:
Adult
Analgesia - methods
Analgesics
Clinical trials
Control
Crying in infants
Female
Follow-Up Studies
Health aspects
Hot Temperature - therapeutic use
Humans
Immunization
Infant crying
Infant, Newborn
Infants (Newborn)
Male
Newborn babies
Newborn infants
Pacifiers
Pain
Pain - drug therapy
Pain - etiology
Pain Management
Pain Measurement
Pediatrics
Radiant heating
Reference Values
Retrospective Studies
Sucrose
Sucrose - therapeutic use
Sweetening Agents - therapeutic use
Treatment Outcome
Vaccination
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Summary:Increasing data suggest that neonatal pain has long-term consequences. Nonpharmacologic techniques (sucrose taste, pacifier suckling, breastfeeding) are effective and now widely used to combat minor neonatal pain. This study examined the analgesic effect of sucrose combined with radiant warmth compared with the taste of sucrose alone during a painful procedure in healthy full-term newborns. A randomized, controlled trial included 29 healthy, full-term newborns born at the University of Chicago Hospital. Both groups of infants were given 1.0 mL of 25% sucrose solution 2 minutes before the vaccination, and 1 group additionally was given radiant warmth from an infant warmer before the vaccination. We assessed pain by comparing differences in cry, grimace, heart rate variability (ie, respiratory sinus arrhythmia), and heart rate between the groups. The sucrose plus warmer group cried and grimaced for 50% less time after the vaccination than the sucrose alone group (P < .05, respectively). The sucrose plus warmer group had lower heart rate and heart rate variability (ie, respiratory sinus arrhythmia) responses compared with the sucrose alone group (P < .01), reflecting a greater ability to physiologically regulate in response to the painful vaccination. The combination of sucrose and radiant warmth is an effective analgesic in newborns and reduces pain better than sucrose alone. The ready availability of this practical nonpharmacologic technique has the potential to reduce the burden of newborn pain.
ISSN:0031-4005
1098-4275
DOI:10.1542/peds.2014-1073