Sucrose + Warmth: Effective Analgesic for Neonatal Pain?
Long-term consequences of neonatal pain include a possible exaggerated response to pain in later infancy and the neurotoxicity of untreated pain in the developing brain. Non-pharmacologic therapies such as breastfeeding have been shown to reduce pain response in infants, but it can be difficult to incorporate this practice into hospital protocols. Sucrose has also been identified as having an analgesic effect for minor neonatal pain, so a new study in Pediatrics sought to evaluate the effects of sucrose with radiant warmth vs. sucrose along during a minor painful procedure in healthy full-term newborns.
In this randomized controlled trial, 29 healthy, full-term newborns were assigned to five minutes of radiant warmth from an infant warmer followed by 1.0mL of 25% sucrose solution two minutes before hepatitis B vaccination or sucrose only. Pain was assessed by comparing differences in cry, grimace, heart rate variability (ie, respiratory sinus arrhythmia, or RSA), and heart rate between the groups.
The sucrose plus warmer group cried and grimaced for 50% less time after the immunization compared to the sucrose only group; the sucrose plus warmer group had lower heart rate and heart rate variability (RSA) responses compared with the sucrose alone group. When breastfeeding is not feasible as an analgesic for neonatal pain, sucrose plus warmth may be an alternative nonpharmacologic treatment for pain associated with minor procedures.
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