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Sucrose May Not Be Effective Analgesic in Newborns

Appears to alter facial expressions but not to actually relieve pain

THURSDAY, Sept. 2 (HealthDay News) -- The common practice of using a sucrose solution to provide analgesia for newborns undergoing painful procedures may alter newborns' facial expressions but does not appear to reduce pain activity in the spinal cord or brain, according to research published online Sept. 1 in The Lancet.

Rebeccah Slater, Ph.D., of the University College London, and colleagues conducted a randomized, double-blind, controlled trial of sucrose as an analgesic for procedural pain in newborn infants. The 44 infants included in the analysis underwent clinically indicated heel sticks for blood collection; two minutes before the heel stick, one group received 0.5 ml of a 24 percent sucrose solution and the other group received sterile water. Pain responses in the brain were recorded with neonatal electroencephalography, and spinal reflex activity was recorded with electromyography.

The researchers found no significant differences in nociceptive brain activity between the two groups. Spinal nociceptive reflex withdrawal recorded from the biceps femoris of the stimulated leg was also not different between groups. The premature infant pain profile (PIPP) score (observational pain score), however, was significantly lower in the sucrose group, leading the authors to conclude that, while oral sucrose did change the newborns' facial expressions, it did not significantly affect brain or spinal cord nociceptive circuits, and therefore might not be effective as an analgesic.

The authors of an accompanying comment state that, statistically, the study has only a one in three chance of detecting a medium effect size difference and a much smaller chance of detecting a small effect size difference. "Therefore we should not be surprised that the study failed to detect an effect of sucrose on cortical evoked responses," they write, but add that, "despite the limitations outlined above, Slater and colleagues' study adds an important and innovative measurement to evaluating pain management in newborn babies."

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