Sucrose for analgesia in preterm infants:a clinical randomized controlled trial / 中华实用儿科临床杂志

ABSTRACT

Objective To explore the analgesic efficacy and stability of oral sucrose for the treatment of procedural pain in preterm infants,then to evaluate the effect of repetitive oral sucrose on glucose metabolism.Methods Eighty-two preterm infants (gestational age ≤34 weeks,birth weight ≤2 000 g)who were admitted to Neonatal Intensive Care Unit in Shenzhen Nanshan Maternity and Child Health Care Hospital between January 2014 and October 2016 were randomized into an intervention group (n =42) and a control group (n =40).The intervention group received a pretreatment with 0.3-0.5 mL of 120 g/L sucrose solution bemore a painful procedure was executed.But the control group only received usual care.The two groups were compared for the changes in heart rate (HR),blood pressure (BP),percutaneous oxygen saturation(SPO2) in pre-and post-painful procedure and the duration of the HR recovering to pre-procedure level.The variations of Neonatal Infant Pain Scale (NIPS) of pre-and post-painful procedure were compared in each group and between 2 groups during the first 4 weeks of life.Finally,the concentrations of fasting blood glucose,the level of insulin,and glucose-to-insulin ratio were compared between the 2 groups on the day of discharge.Results The variations in HR,BP,NIPS and SPO2 between pre-and post-painful procedure were lower in the intervention group than those in the control group [(10.59 ± 5.50) times/min vs.(20.75 ± 14.18) times/min;(1.86 ± 2.45) mmHg vs.(3.64 ± 1.78) mmHg (1 mmHg =0.133 kPa);(2.11 ± 0.93) scores vs.(3.25 ± 1.21)scores;(0.71 ± 0.53) ％ vs.(1.03 ± 0.54) ％],and the differences were statistically significant (t =-3.298,-3.008,-4.084,-2.195;P =0.002,0.004,0.001,0.033).Meanwhile,there was a shorter duration of the HR recovery to pre-procedure level in intervention group compared with the control group[(36.27 ±9.86) s vs.(54.72 ±26.43) s,t =-3.093,P =0.004].The variations in NIPS of pre-and post-procedures showed no significant difference in the 2 groups during the first 4 weeks (F =0.188,P =0.904).The concentrations of fasting blood glucose,the level of insulin,and glucose-to-insulin ratio were similar between the 2 groups when the infants were discharged [(4.73 ± 0.85) mmol/L vs.(4.96 ± 0.83) mmol/L,P =0.411;(6.30 ± 13.65) mU/L vs.(6.44 ± 8.60) mU/L,P =0.969;0.069 ± 0.135 vs.0.096 ± 0.108,P =0.567].Conclusions Oral sucrose (120 g/L) has an effective and stable analgesic effect on preterm neonates pain stimulation,but no significant effect on glucose metabolism.