THE EFFECTIVENESS OF ORAL SUCROSE ON PAIN DURING INVASIVE PROCEDURES IN PREMATURE INFANTS: SCOPING REVIEW

Introduction: Nowadays premature births continue to be common, it caused the infant necessitating treatment. Invasive procedures, such as the placement of an peripheral intravenous catheters or the drawing of blood, should be carried out while the baby is being cared for. Some intervention needed, sucrose is one approach to make invasive procedure less painful. This study aims to determine the effectiveness of oral sucrose in reducing the pain of invasive procedures in premature infants. Method: This study is a scoping review, and 11 articles were selected from Proquest, ScienceDirect, Willy Online, PubMed, and EBSCO (CINAHL) databases. Results: In eight of the articles, giving oral sucrose two minutes before the invasive procedure was effective in reducing pain, while sucrose was not effective in reducing pain in infants in the other three of the articles, during or after procedures. Conclusion: According to these studies, giving oral sucrose to premature infant before invasive procedure is significant reducing the pain during invasive procedure.

Sex-specific effects of neonatal oral sucrose treatment on growth and liver choline and glucocorticoid metabolism in adulthood

Hospitalized preterm infants experience painful medical procedures. Oral sucrose is the non‑pharmacological standard of care for minor procedural pain relief. Infants are treated with numerous doses of sucrose, raising concerns about potential long-term effects. The objective of this study was to determine the long‑term effects of neonatal oral sucrose treatment on growth and liver metabolism in a mouse model. Neonatal female and male mice were randomly assigned to one of two oral treatments (n=7‑10 mice/group/sex): sterile water or sucrose. Pups were treated 10 times/day for the first six days of life with 0.2mg/g body weight of respective treatments (24% solution; 1‑4μl/dose) to mimic what is given to preterm infants. Mice were weaned at age 3 weeks onto a control diet and fed until age 16 weeks. Sucrose-treated female and male mice gained less weight during the treatment period and were smaller at weaning than water-treated mice (p≤0.05); no effect of sucrose treatment on body weight was observed at adulthood. However, adult sucrose-treated female mice had smaller tibias and lower serum insulin-like growth factor-1 than adult water-treated female mice (p≤0.05); these effects were not observed in males. Lower liver S-adenosylmethionine, phosphocholine, and glycerophosphocholine were observed in adult sucrose-treated compared to water-treated female and male mice (p≤0.05). Sucrose-treated female, but not male, mice had lower liver free choline and higher liver betaine compared to water-treated female mice (p<0.01). Our findings suggest that repeated neonatal sucrose treatment has long-term sex-specific effects on growth and liver methionine and choline metabolism.

Oral Sucrose Improves Analgesia During Retinopathy of Prematurity Screening

Purpose To determine whether sucrose provides significant analgesia during Retinopathy of Prematurity (ROP) screening Methods This was a prospective, randomized, sinlge masked audit. The examinations were performed by a single examiner. Forty-five (45) neonates were separated into two groups; Group 1 received oral sucrose while Group 2 received oral sucrose and non-nutritive suckling (NNS) at the discretion of the attending nurse. Pain was assessed using the Premature Infant Pain Profile (PIPP) score and recorded at baseline, immediately following lid speculum, at 3 minutes and 6 minutes following lid speculum insertion. Results The mean baseline PIPP score was 0.5. Fifteen (15) neonates (33%) received NNS. The mean PIPP scores at speculum insertion in both groups (Group 1: 7.24, Group 2: 5.50) were observed to be higher than at baseline and lower in Group 2 than in Group 1. In both groups, the scores at 3 minutes (Group 1: 4.70, Group 2: 4.20) and 6 minutes (Group 1 4.50, Group 2: 4.70) were observed to be higher than at baseline, lower than at speculum insertion, but not significantly different to each other. Conclusions Lid speculum insertion during ROP screening appears to be a significantly painful event. ROP examinations should be conducted with a combination of topical analgesia and sucrose and NNS for greatest pain-relieving effect.

Effectiveness of Oral Sucrose on Level of Pain during DPT Immunization among Infants at selected hospital Salem, Tamil Nadu

Evidence shows that neonates feel pain. Treating pain of infants at the time of immunizations has become a crucial part of infant care. Pharmacological treatments are rarely used during procedures because of concerns about their effectiveness3 and potential adverse effects. Therefore, non-pharmacological interventions are valuable alternatives. Use of sucrose in preterm neonates has been advocated uniformly for pain relief. The present study had taken with the aim to assess the effectiveness of oral sucrose on level of pain during DPT immunizations among infants. Study design was quasi experimental method. Sample size of the study was 60 infants who were receiving DPT immunizations at Salem Poly Clinic. Data were collected from the subjects through Modified REILY pain assessment scale. Data analysis was done through descriptive and inferential statistics. Results of the study revealed the mean level of pain for experimental group 8.03+0.91 (53.53%) where as in control group it was 11.53+1.17 (77.53%) the difference in mean percentage was 24, which indicates decreased level of pain in experimental group than in control group. The researcher concluded that giving oral sucrose during the time of vaccination in infants acts as an effective non – pharmacological measure for pain management.

“Holding–Cuddling” and Sucrose for Pain Relief During Venepuncture in Newborn Infants: A Randomized, Controlled Trial (CÂSA)

Objectives: Oral sucrose is commonly used to provide analgesia to neonates during painful procedures, such as venepuncture. The additional benefits of reducing pain during venepuncture when oral sucrose is combined with nonpharmacological strategies have not been extensively studied. This randomized controlled trial compared the efficacy of oral sucrose with nonnutritive sucking vs. oral sucrose with nonnutritive sucking plus “holding–cuddling” for pain management during venepuncture in term infants from birth to 3 months of life.Methods: Seventy-eight infants were equally randomized to receive 24% oral sucrose with nonnutritive sucking (control group) or 24% oral sucrose with nonnutritive sucking plus “holding–cuddling” (being held in a secure, cuddling position; experimental group) before venepuncture. Behavioral response to pain was measured by the 0–10 ranking scale “acute pain for neonates (APN)” at 30 and 60 s after venepuncture.Results: Within the study sample, APN scores were ≥ 2 for 32/68 (47%) infants. “Holding–cuddling” did not significantly reduce mean APN scores at 30 and 60 s, but the rate of infants experiencing a high pain score (APN ≥ 8) at 60 s after the venepuncture was significantly lower in the experimental group compared to controls [4/34 vs. 12/34 (p = 0.04)].Conclusions: Venepuncture is a painful procedure in newborn and young infants. The implementation of behavioral strategies in association with oral sucrose may mitigate pain during this procedure.Clinical Trial Registration: This trial was registered at http://clinicaltrials.gov/ (NCT number 02803723).

Oral Sucrose for Neonatal Pain: Perception of Jordanian Nurses

BackgroundNeonatal pain management using sucrose has been an established practice in Western countries. However, in the developing world, the practice is still not widely accepted. Neonatal nurses' perceptions about the neonatal pain experience and efficacy of oral sucrose may influence that decision.PurposeTo investigate Jordanian neonatal nurses' perceptions about the use of oral sucrose for neonatal pain.Design and SampleA cross-sectional descriptive design was used to collect data from 191 neonatal nurses working in 3 different hospital settings in northern and middle central Jordan.Main Outcome VariablesKnowledge and perception of Jordanian nurses about neonatal pain and oral sucrose and their relationship to demographic variables.ResultsMore than half of nurses had knowledge deficit about pain management. Fifty-five percent of the nurses had a positive perception toward pain assessment tools, and the majority indicated positive opinion toward oral sucrose usage. Demographic factors can impact their perceptions.