title: Lingual sucrose reduces the pain response to nasogastric tube insertion: a randomised clinical trial.
abstract: OBJECTIVE
  To determine whether lingual sucrose modifies the pain response to nasogastric tube insertion in preterm infants.
  
  
  METHODS
  Randomised, double-blind, placebo controlled clinical trial.
  
  
  METHODS
  Special care baby unit.
  
  
  METHODS
  20 stable preterm infants who required nasogastric tube insertion for feeding, randomised on 51 occasions.
  
  
  METHODS
  Lingual 24% sucrose or water placebo (0.5-2 ml varying with body weight) administered 2 min before nasogastric tube insertion.
  
  
  METHODS
  Heart rate, oxygen saturation (SaO2), Neonatal Facial Coding Score and presence or absence of cry.
  
  
  RESULTS
  Infants who received sucrose demonstrated a significantly lower Neonatal Facial Coding Score during nasogastric tube passage compared with the placebo group (median 1 (range 0-4) vs 3 (0-4), p = 0.004). There was a trend for sucrose-treated infants to have little change in heart rate during nasogastric tube passage compared with the placebo group (mean (SD) -0.73 (23) vs +11 (17), p = 0.055). Mean SaO2 did not change significantly. Pain response measurements quickly returned to baseline after nasogastric tube insertion. Adverse effects, such as apnoea or oxygen desaturation, were few and occurred equally in each group.
  
  
  CONCLUSIONS
  Nasogastric tube insertion induces a pain response comparable with previously reported responses to heel lance in neonates. Single-dose lingual 24% sucrose is effective in reducing the behavioural and physiological pain response to nasogastric tube insertion in preterm infants and it appears to be safe.
authors.affiliation: Department of Child Health, Rotherham General Hospital, Moorgate Road, Rotherham, South Yorkshire S60 2UD, UK.
authors.forename: S
authors.initials: S
authors.lastname: McCullough
authors.forename: T
authors.initials: T
authors.lastname: Halton
authors.forename: D
authors.initials: D
authors.lastname: Mowbray
authors.forename: P I
authors.initials: PI
authors.lastname: Macfarlane
mesh_terms: D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007441:Intubation, Gastrointestinal / Q000009:adverse effects / Q000379:methods*; D008297:Male; D010147:Pain Measurement / Q000379:methods; D013395:Sucrose / Q000008:administration & dosage* / Q000009:adverse effects; D013549:Sweetening Agents / Q000008:administration & dosage* / Q000009:adverse effects; D016896:Treatment Outcome
chemical_list: D013549:Sweetening Agents; D013395:Sucrose