1.
Oral sucrose for pain control in nonneonate infants during minor painful procedures.
McCall, JM, DeCristofaro, C, Elliott, L
Journal of the American Association of Nurse Practitioners. 2013;(5):244-52
Abstract
PURPOSE To provide information regarding the effective use of oral sucrose as an analgesic for immunization and venipuncture procedures in the older infant. DATA SOURCES Evidence-based literature including original clinical trials, reviews, and clinical practice guidelines. CONCLUSIONS Most infants are exposed to multiple minor painful procedures during the first year of life. Oral sucrose solution in a 24% concentration at a dose of 2 mL approximately 2 min prior to the painful procedure has been shown effective in reducing pain during immunizations and venipuncture in the outpatient setting in infants aged 1-12 months old. IMPLICATIONS FOR PRACTICE Oral sucrose solution should be used as a pain reduction intervention in infants up to 12 months of age undergoing minor painful procedures. Its proven effectiveness as an analgesic, low rate of minor adverse events, ease of administration, and excellent availability make sucrose a good choice for this purpose. Additional research is needed regarding dose response in different infant age groups, optimal concentration of sucrose solution, need for multiple sucrose dosing, adjustment for multiple painful procedures, and addition of optimal nonpharmacologic interventions as a combination approach.
2.
Effectiveness of oral sucrose for pain management in infants during immunizations.
Curry, DM, Brown, C, Wrona, S
Pain management nursing : official journal of the American Society of Pain Management Nurses. 2012;(3):139-49
Abstract
This study examined the effects of oral sucrose as an analgesic agent during routine immunization for infants at 2, 4, and 6 months of age. A sample of 113 healthy infants were recruited from three ambulatory clinics and randomly assigned to one of three treatment groups. Infants were given 2 mL orally of either 50% sucrose, 75% sucrose, or sterile water 2 minutes before administration of immunizations. No significant difference was found among the different age groups with the different treatments for pain as measured with the FLACC scores and crying time. Consolability factors are felt to have some influence.
3.
Sucrose decreases infant biobehavioral pain response to immunizations: a randomized controlled trial.
Hatfield, LA
Journal of nursing scholarship : an official publication of Sigma Theta Tau International Honor Society of Nursing. 2008;(3):219-25
Abstract
PURPOSE To evaluate the effectiveness and age-related changes in analgesia of oral sucrose as a preprocedural intervention during routine immunizations in infants at 2 and 4 months of age. DESIGN A double-blind, randomized, placebo-controlled clinical trial of 40 healthy term infants scheduled to receive routine immunizations from a pediatric ambulatory care clinic during May 2005 to July 2005. METHODS Infants received 24% oral sucrose solution or the control solution of sterile water 2 minutes before routine immunizations at both their 2- and 4-month, well-child visits. The University of Wisconsin Children's Hospital pain scale was used to measure serial acute behavioral pain responses at baseline, 2, and 5 minutes after administration of the solution. Repeated measures ANOVA was used to examine between-group differences and within-subject variability of the effects of treatment on overall behavioral pain scores. FINDINGS Infants receiving oral sucrose (n=20) showed a significant reduction in behavioral pain response 5 minutes after administration compared to those in the placebo group (n=20). At 2 minutes following solution administration, both sucrose and sterile water showed the highest mean pain score (4.54 and 4.39 respectively) indicating a severe amount of pain. At 5 minutes, the sucrose group returned to near normal at 0.27 while the placebo group remained at 3.02 indicating a percentage difference in mean pain scores relative to sterile water pain scores of 90.9. No statistically significant age-related change in behavioral pain response was noted between 2- and 4-month-old infants at 2 minutes and 5 minutes following treatment administration. CONCLUSION Sucrose is an effective preprocedural intervention for decreasing behavioral pain response in infants after immunizations. CLINICAL RELEVANCE Efforts to decrease the pain associated with immunizations can promote parental adherence to recommended immunizations schedules, prevent a resurgence of vaccine-preventable diseases and mitigate adverse neurologic outcomes in infants.