Analgesic Effect of Oral Glucose and Pacifiers in Term Neonates during Minor Procedures

Kim, Ki Soo; Cho, Eun Young; Lim, Jae Woo; Cheon, Eun Jung; Ko, Kyong Og; Lee, Young Hyuk; Kim, Kir Young

Abstract

PURPOSE
Newborns may undergo many kinds of minor procedures. Since painful events during procedures may cause adverse effects on growth and/or development, nonpharmacological way to relive pain have been extensively studied including oral glucose and pacifiers. This study was undertaken to evaluate the analgesic effects of orally administered glucose and pacifiers in term neonates during minor procedures using validated behavioral pain rating system. METHODS: Randomized prospective studies with 81 term infants were assigned to one of three treatment groups: placebo (2 ml sterile water), glucose (2 ml 30% glucose), and pacifier (2 ml 30% glucose followed by a pacifier) during heelsticks. Intensity of pain was assessed by Douleur Aigue Nouveau-ne scale (DAN scale). RESULTS: Median pain scores (interquartile) during minor procedure and after 30 seconds were 7 (6-10), 4 (3-8) for sterile water; 7 (3-8), 1 (0-5) for 30% glucose; 4 (2-6), 1 (0-1) for 30% glucose and pacifiers, respectively. P values for comparisons of sterile water versus 30% glucose, and 30% glucose versus 30% glucose plus pacifiers were 0.019, 0.035 for during the procedure and 0.006, 0.034 for after 30 seconds, respectively. CONCLUSION: The analgesic effect of oral glucose during minor procedure is clinically apparent in full term neonates. Pacifiers plus glucose have a synergetic analgesic effect in neonates. These simple and safe interventions should be widely used during minor procedures in term neonates.