[Oral sugar solutions in pain therapy of neonates and premature infants].
OBJECTIVE
We review the efficacy of oral sugar solutions for treating procedural pain in neonates and address the following questions: Do newborns need analgesic therapy for procedural pain during blood sampling? How do sugars influence pain-reactions of neonates? What is the efficacy of sugar solutions in clinical practice?


METHODS
We searched for relevant articles in the PubMed database from 1990 to September 2000.


RESULTS
Treatment of procedural pain in newborns is desirable because they are more sensitive to pain than adults, they show marked pain reactions during blood sampling and repeated acute pain in the newborn period results in longterm behavioural changes. Oral sugar solutions have been studied for treatment of procedural pain in neonates. Their initial effect is the result of orotactile stimulation by the intraoral fluid. The orogustatory stimulation by the sweet taste prolongs the effect for up to 10 minutes through endorphin release. In randomized-controlled trials oral sugar solutions (2 ml of 25% sucrose or 30% glucose) reduced pain reactions and crying and attenuated the heart rate increase after capillary and venous blood sampling in term and preterm neonates. They are more effective than traditional calming strategies, like cuddling by parents, use of a pacifier, or breast feeding. Yet, sugar solutions provide no adequate analgesia for more severe pain, e.g. during circumcision.


CONCLUSIONS
Sugar solutions effectively relieve procedural pain during blood sampling in neonates. Additional studies are needed to determine the minimal effective dose and the efficacy and side effects of repeated sugar doses in the same patient.
Bauer
K
K
Abteilung für Kinderheilkunde mit Schwerpunkt Neonatologie, Freie Universität Berlin, Universitätsklinikum Benjamin Franklin, Berlin. bauer@medizin.fu-berlin.de
Versmold
H
H
D000698:Analgesia; D001143:Arousal / Q000187:drug effects / Q000502:physiology; D001800:Blood Specimen Collection; D019422:Dietary Sucrose / Q000008:administration & dosage*; D004723:Endorphins / Q000097:blood; D005950:Glucose Solution, Hypertonic / Q000008:administration & dosage*; D006801:Humans; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000188:drug therapy* / Q000503:physiopathology; D010146:Pain / Q000188:drug therapy* / Q000503:physiopathology; D017288:Pain Threshold / Q000187:drug effects / Q000502:physiology
D019422:Dietary Sucrose; D004723:Endorphins; D005950:Glucose Solution, Hypertonic