Sucrose decreases infant biobehavioral pain response to immunizations: a randomized controlled trial.

Abstract

PURPOSE:

To evaluate the effectiveness and age-related changes in analgesia of oral sucrose as a preprocedural intervention during routine immunizations in infants at 2 and 4 months of age.

DESIGN:

A double-blind, randomized, placebo-controlled clinical trial of 40 healthy term infants scheduled to receive routine immunizations from a pediatric ambulatory care clinic during May 2005 to July 2005.

METHODS:

Infants received 24% oral sucrose solution or the control solution of sterile water 2 minutes before routine immunizations at both their 2- and 4-month, well-child visits. The University of Wisconsin Children's Hospital pain scale was used to measure serial acute behavioral pain responses at baseline, 2, and 5 minutes after administration of the solution. Repeated measures ANOVA was used to examine between-group differences and within-subject variability of the effects of treatment on overall behavioral pain scores.

FINDINGS:

Infants receiving oral sucrose (n=20) showed a significant reduction in behavioral pain response 5 minutes after administration compared to those in the placebo group (n=20). At 2 minutes following solution administration, both sucrose and sterile water showed the highest mean pain score (4.54 and 4.39 respectively) indicating a severe amount of pain. At 5 minutes, the sucrose group returned to near normal at 0.27 while the placebo group remained at 3.02 indicating a percentage difference in mean pain scores relative to sterile water pain scores of 90.9. No statistically significant age-related change in behavioral pain response was noted between 2- and 4-month-old infants at 2 minutes and 5 minutes following treatment administration.

CONCLUSION:

Sucrose is an effective preprocedural intervention for decreasing behavioral pain response in infants after immunizations.

CLINICAL RELEVANCE:

Efforts to decrease the pain associated with immunizations can promote parental adherence to recommended immunizations schedules, prevent a resurgence of vaccine-preventable diseases and mitigate adverse neurologic outcomes in infants.

• Authors: Linda A Hatfield
• Journal: Journal of nursing scholarship : an official publication of Sigma Theta Tau International Honor Society of Nursing (J Nurs Scholarsh) Vol. 40 Issue 3 Pg. 219-25 ( 2008) ISSN: 1547-5069 [Electronic] United States
• PMID: 18840204 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Solutions
• Sweetening Agents
• Sucrose

Topics

• Administration, Oral
• Analysis of Variance
• Clinical Nursing Research
• Crying
• Double-Blind Method
• Facial Expression
• Humans
• Infant
• Infant Behavior
• Nursing Assessment
• Pain (diagnosis, etiology, prevention & control, psychology)
• Pain Measurement
• Premedication (methods, nursing)
• Prospective Studies
• Severity of Illness Index
• Solutions
• Sucking Behavior
• Sucrose (therapeutic use)
• Sweetening Agents (therapeutic use)
• Treatment Outcome
• Vaccination (adverse effects)