Oral sucrose compares favourably with lidocaine-prilocaine cream for pain relief during venepuncture in neonates.
To compare the relative efficacy of oral sucrose versus EMLA cream for pain relief during venepuncture, 51 full-term newborns (38M, 13F; postnatal age <4 d) in a stable condition were randomly allocated to one of four treatment groups: placebo (2 ml spring water); 2 ml sucrose 24% w/v; 1 g lidocaine-prilocaine 5% cream (EMLA); or EMLA plus sucrose. Water or a single dose of sucrose solution was administered orally 2 min before venepuncture. EMLA cream was applied in the antecubital fossa 45-60 min before venepuncture and covered by a Tegaderm dressing. A pacifier was given before skin puncture, but it was not actively held or replaced during the procedure or observation periods. In total, 55 venepunctures were performed blindly, always for clinical reasons. As indicators of pain, the total crying time was recorded and heart rate, respiratory rate and arterial oxygen saturation were measured blindly at baseline, immediately post-venepuncture, and 2 and 4 min afterwards. The main effects observed were: (i) time spent crying decreased significantly in the sucrose alone (p = 0.001) and EMLA plus sucrose (p = 0.008) groups; (ii) the above treatments attenuated significantly (p < 0.05) the immediate heart rate response to pain; and (iii) the concomitant use of EMLA did not increase further the analgesic efficacy of sucrose.


CONCLUSIONS
This study shows that a 24% oral sucrose solution compares favourably with EMLA cream as a safe and cheap analgesic procedure to decrease pain responses to venepuncture in newborns.
Research Unit, Hospital La Candelaria, Tenerife, Spain. dperez@ene.es
F
F
Abad
N M
NM
Díaz-Gómez
E
E
Domenech
D
D
González
M
M
Robayna
M
M
Feria
D000284:Administration, Oral; D000779:Anesthetics, Local / Q000008:administration & dosage / Q000627:therapeutic use*; D003448:Crying; D004311:Double-Blind Method; D004338:Drug Combinations; D005260:Female; D006339:Heart Rate; D006801:Humans; D007231:Infant, Newborn; D008012:Lidocaine / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D009824:Ointments; D010146:Pain / Q000188:drug therapy* / Q000209:etiology*; D018962:Phlebotomy / Q000009:adverse effects*; D011318:Prilocaine / Q000008:administration & dosage / Q000627:therapeutic use*; D011446:Prospective Studies; D012119:Respiration; D013395:Sucrose / Q000008:administration & dosage / Q000627:therapeutic use*
D000779:Anesthetics, Local; D004338:Drug Combinations; D009824:Ointments; D011318:Prilocaine; D013395:Sucrose; D008012:Lidocaine