Analgesic Effects of EMLA Cream and Oral Sucrose During Venipuncture in Preterm Infants

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.

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Oral Sucrose and a Pacifier for Pain Relief During Simple Procedures in Preterm Infants: A Randomized Controlled Trial

Annals of Saudi Medicine ◽

10.5144/0256-4947.52821 ◽

2009 ◽

Vol 29 (3) ◽

pp. 184-188 ◽

Cited By ~ 32

Author(s):

Fathia A. Elserafy ◽

Saad A. Alsaedi ◽

Julita Louwrens ◽

Bakr Bin Sadiq ◽

Ali Y. Mersal

Keyword(s):

Randomized Controlled Trial ◽

Pain Relief ◽

Preterm Infants ◽

Controlled Trial ◽

Randomized Controlled ◽

Oral Sucrose

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Evidence-Based Review of Oral Sucrose Administration to Decrease the Pain Response in Newborn Infants

Neonatal Network The Journal of Neonatal Nursing ◽

10.1891/0730-0832.25.4.275 ◽

2006 ◽

Vol 25 (4) ◽

pp. 275-284 ◽

Cited By ~ 9

Author(s):

Kathleen Leef

Keyword(s):

Preterm Infants ◽

Newborn Infants ◽

Pain Response ◽

Evidence Based ◽

Invasive Procedures ◽

Term Infants ◽

Safety And Efficacy ◽

Single Procedure ◽

Repeated Doses ◽

Oral Sucrose

Pain assessment and management are important issues for the neonatal nurse today. Clinicians have gradually come to acknowledge that newborn infants (term and preterm) are capable of responding to painful stimuli. This article reviews the evidence regarding the safety and efficacy of oral sucrose administration, to help answer the clinical question of how to manage an infant’s pain response to minor invasive procedures that are everyday occurrences in the NICU. This review included information on 1,077 infants enrolled in 16 studies. The evidence presented in the 16 studies reviewed here shows the safety and efficacy of sucrose in decreasing term infants’ pain response to a single procedure. In regard to preterm infants, there is insufficient evidence to recommend the use of sucrose as a routine comfort measure. More research is needed to determine the safety and efficacy of repeated doses of oral sucrose given for multiple procedures in preterm infants.

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