EFFECTIVENESS OF ORAL SUCROSE AND SIMULATED ROCKING ON PAIN RESPONSE IN PRETERM NEONATES

Feeding and carrying have been interventions used by caregivers throug hout history in relieving distress in infants. Recent studies on the f ood substance sucrose have elucidated the comforting effect of the tas te component of feeding while studies of rocking have examined the com forting effect of the vestibular component of carrying. The purpose of this study was to determine the effectiveness of sucrose and simulate d rocking alone and in combination on diminishing pain response in pre term neonates undergoing routine heelstick procedure in the neonatal i ntensive care unit (NICU), Preterm infants (n = 85) between 25-34 week s post-conceptual age (PCA) and 2-10 days postnatal age (PNA) were ran domly assigned to one of four conditions for routine heelstick procedu re. The conditions were (1) sucrose alone: 0.05 ml of 24%, sucrose was placed on the anterior surface of the tongue just prior to the lancin g of the heel; (2) simulated rocking alone: 15 min prior to and during the heelstick procedure, the infant was swaddled and pur on an oscill ating mattress; (3) combination of sucrose and simulated rocking; and (4) placebo: 0.05 ml sterile water administered just prior to heelstic k. Physiological (heart rate) and behavioural (facial actions) respons es from baseline across 90 s following heelstick were scored second-to -second. Facial actions were analysed with repeated measures MANCOVA a nd heart rate with repealed measures ANCOVA.:Behavioural state and ges tational age were covariates. The groups that received sucrose alone o r in combination with simulated rocking showed less facial actions ind icative of pain than the rocking alone or control group. The addition of rocking to the sucrose condition tended to further blunt the facial expression of pain, but this enhancement did not reach a significant level. Heart rate was not decreased by any intervention compared to th e control condition. Although the simulated rocking did promote quiet sleep, which has been reported in earlier studies to blunt pain respon se, there was no difference between simulated rocking and control grou ps in either facial expressions indicative of pain or heart rate. The implication of these results is that sucrose, but not simulated rockin g may be a means of diminishing pain from minor procedures in preterm infants. Further research is needed on the use of sucrose for more tha n one procedure as well as examining the contact component of natural rocking, as opposed to simulated rocking. (C) 1997 International Assoc iation for the Study of Pain. Published by Elsevier Science B.V.