Randomised trial of analgesic effects of sucrose, glucose, and pacifiers in term neonates

Objectives To assess and compare the analgesic effects of orally administer ed glucose and sucrose and pacifiers. To determine the synergistic analgesi c effect of sucrose and pacifiers. Design Randomised prospective study with validated behavioural acute pain r ating scale. Setting Maternity ward. Participants 150 term newborns undergoing venepuncture randomly assigned to one of six treatment groups: no treatment; placebo (2 ml sterile water); 2 ml 30% glucose; 2 ml 30% sucrose; a pacifier; and 2 ml 30% sucrose followe d by a pacifier. Results Median (interquartile) pain scores during venepuncture were 7 (5-10 ) for no treatment; 7 (6-10) for placebo (sterile water); 5 (3-7) for 30% g lucose; 5 (2-8) for 30%, sucrose; 2 (1-4) for pacifier; and 1 (1-2) for 30% sucrose plus pacifier. Mann-Whitney U test P values for comparisons of 30% glucose, 30% sucrose, pacifier, and 30% sucrose plus pacifier versus place bo (sterile water) were 0.005, 0.01, < 0.0001, and < 0.0001, respectively. Differences between group median pain scores for these comparisons were 2 ( 95% confidence interval 1 to 4), 2 (0 to 4), 5 (4 to 7), and 0 (5 to 8), re spectively P values for comparisons of 30% glucose, 30% sucrose, and 30% su crose plus pacifier versus pacifier were 0.0001, 0.001, and 0.06, respectiv ely. Differences between group medians for these comparisons were 3 (2 to 5 ), 3 (1 to 5), and 1 (0 to 2), respectively. Conclusion nle analgesic effects of concentrated sucrose and glucose and pa cifiers are clinically apparent in newborns, pacifiers being more effective than sweet solutions. The association of sucrose and pacifier showed a tre nd towards lower scores compared with pacifiers alone. These simple and saf e interventions should be widely used for minor procedures in neonates.