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Sweet Baby James: Oral Glucose Reduces Pain in Newborns

This intervention is a sweet solution for the pain of medical procedures in neonates.

Recent studies show that reducing the pain of procedures in neonates has long-term benefits. Previous studies support the effectiveness of sweet oral solutions for reducing signs of pain. The analgesic mechanism may be associated with the release of endorphins or may be a local effect related to the sweet taste.

This randomized, controlled, double-blind study of 201 full-term newborns undergoing venipuncture was conducted to compare the analgesic effects of a 30% solution of oral glucose with the effects of EMLA, an anesthetic cream. During the procedure, 91 newborns received topical EMLA (0.5 g) on the dorsal hand and oral sterile water, and 102 received placebo cream on the hand and the oral glucose solution. Pain was assessed on a validated scale that measured brow bulge, eye squeeze, nasolabial furrow, heart rate, and oxygen saturation for 30 seconds after each venipuncture. Pacifier or finger sucking during the procedure was encouraged in both groups.

Pain scores after venipuncture were significantly lower in the glucose group than in the EMLA group. Signs indicating pain were recorded in 19.3% of the glucose group and 41.7% of the EMLA group. Changes in heart rate were similar in both groups.

Comment: These findings validate a safe intervention for reducing procedure-associated pain in newborns. Some of the benefit of oral glucose may have resulted from more frequent use of oral pacifiers in that group, but many infants in both groups did not use pacifiers, which were clearly not the only source of pain reduction.

— Martin T. Stein, MD

Published in Journal Watch Pediatrics and Adolescent Medicine January 13, 2003

Citation(s):

Gradin M et al. Pain reduction at venipuncture in newborns: Oral glucose compared with local anesthetic cream. Pediatrics 2002 Dec; 110:1053-7.

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