New study on Sucrose as an analgesic in newborns

[ASusan]

This study is coming out in The Lancet tomorrow.

Double-blind, randomized controlled trials of sucrose vs water for newborns undergoing a heel lance. They measured pain sensation in the spinal cord (reflexive) and brain (via eeg) AND behavioral observations of withdrawal and facial expression. There was NO difference between sucrose and water for the spinal cord and brain measures of pain reception, but there was a significant difference in behaviors. The sucrose group made fewer grimaces and had lower observed pain scores on a standardized pain observation measure. SO, the conclusion is that giving sugar *looks* like it works as an analgesic, but the infants still respond and feel the pain.


Oral sucrose as an analgesic drug for procedural pain in newborn infants: a randomised controlled trial

The Lancet, Volume 376, Issue 9748, Pages 1225 - 1232, 9 October 2010
Dr Rebeccah Slater PhD, Laura Cornelissen MSci, Lorenzo Fabrizi PhD, Debbie Patten BSc, Jan Yoxen, Alan Worley MSc, Stewart Boyd MD, Judith Meek MBBS, Prof Maria Fitzgerald PhD
doi:10.1016/S0140-6736(10)61303-7

The study was done in London.

[dinahx]

Duh! The things they have to study!

[Llyra]

Seriously, I'd like to invite the good doctors who studied this to let me give them a mouthful of sugar, and then I'll chop off one of the most sensitive parts of their body-- then they can tell me how well sugar works as an anesthetic.

[Tjej]

Was it really thought to be a pain-killer? I always just assumed it was a distraction for infants - it makes you focus less on the pain, but it wouldn't change it.

Tjej

[BugMacGee]

We were told, by a nurse practitioner on our pain service, that sucrose, in combination with sucking, releases endogenous opioid-like substances. I wonder where she got that info if it isn't actually true. I admit, it's been ages since I have read the supporting evidence. It is widely accepted practice to use it prior to painful procedures. We use it for IV starts. It really seems to work.
This is interesting research. I'd love to learn more.

[brant31]

There has been previous discussion here on TCAS about the advisability and effectiveness of giving a pacifier dipped in SweetEase to male infants undergoing circumcision. The manufacturer of the water/sucrose product doesn't even call it an analgesic; they emphasize that it is an "intervention" for "calming and soothing" babies up to 6 months of age. The same company manufactures the Wee Thumbie pacifier which is made specifically to work with SweetEase. There are also competing brands.

Many physicians and nurses firmly believe that sucrose is an analgesic to some extent or another for babies. The doctor interviewed on the recent Mammoth CA radio show on circumcision endorsed the use of SweetEase and reacted with some surprise to the news that a Lancet study had proved it ineffective for pain. She later said it was really just used as a distraction.

Certainly the sweetness of these sucrose solutions must be jarring to a newborn. From what I have read, infants have a dramatically different taste palate from adults, based largely on the fact that they have been living in a saline sac in the womb for most of their development. Therefore, slightly salty water tastes to a newborn very much like spring water does to an adult, and spring water to a newborn tastes like sugar water or Sprite does to an adult. I can only imagine what off-the-charts creation sugar water tastes like to a newborn; the exaggerated sweetness of it probably induces dizziness or stupor (but not genuine CNS pain reduction).