Lingual sucrose reduces the pain response to nasogastric tube insertion: a randomised clinical trial.
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.
McCullough
S
S
Department of Child Health, Rotherham General Hospital, Moorgate Road, Rotherham, South Yorkshire S60 2UD, UK.
Halton
T
T
Mowbray
D
D
Macfarlane
P I
PI
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
D013549:Sweetening Agents; D013395:Sucrose