title: Sucrose and warmth for analgesia in healthy newborns: an RCT.
abstract: OBJECTIVE
  Increasing data suggest that neonatal pain has long-term consequences. Nonpharmacologic techniques (sucrose taste, pacifier suckling, breastfeeding) are effective and now widely used to combat minor neonatal pain. This study examined the analgesic effect of sucrose combined with radiant warmth compared with the taste of sucrose alone during a painful procedure in healthy full-term newborns.
  
  
  METHODS
  A randomized, controlled trial included 29 healthy, full-term newborns born at the University of Chicago Hospital. Both groups of infants were given 1.0 mL of 25% sucrose solution 2 minutes before the vaccination, and 1 group additionally was given radiant warmth from an infant warmer before the vaccination. We assessed pain by comparing differences in cry, grimace, heart rate variability (ie, respiratory sinus arrhythmia), and heart rate between the groups.
  
  
  RESULTS
  The sucrose plus warmer group cried and grimaced for 50% less time after the vaccination than the sucrose alone group (P < .05, respectively). The sucrose plus warmer group had lower heart rate and heart rate variability (ie, respiratory sinus arrhythmia) responses compared with the sucrose alone group (P < .01), reflecting a greater ability to physiologically regulate in response to the painful vaccination.
  
  
  CONCLUSIONS
  The combination of sucrose and radiant warmth is an effective analgesic in newborns and reduces pain better than sucrose alone. The ready availability of this practical nonpharmacologic technique has the potential to reduce the burden of newborn pain.
authors: Department of Pediatrics, University of Chicago, Chicago, Illinois; larrygray@uchicago.edu.
authors: Larry
authors: L
authors: Gray
authors: Pediatrics, Baylor College of Medicine, Houston, Texas;
authors: Elizabeth
authors: E
authors: Garza
authors: Philadelphia College of Osteopathic Medicine, Philadelphia, Pennsylvania; and.
authors: Danielle
authors: D
authors: Zageris
authors: Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
authors: Keri J
authors: KJ
authors: Heilman
authors: Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
authors: Stephen W
authors: SW
authors: Porges
mesh_terms: D000328:Adult; D000698:Analgesia / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006358:Hot Temperature / Q000627:therapeutic use*; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D041361:Pacifiers; D010146:Pain / Q000188:drug therapy* / Q000209:etiology; D059408:Pain Management; D010147:Pain Measurement; D012016:Reference Values; D012189:Retrospective Studies; D013395:Sucrose / Q000627:therapeutic use*; D013549:Sweetening Agents / Q000627:therapeutic use; D016896:Treatment Outcome; D014611:Vaccination
chemical_list: D013549:Sweetening Agents; D013395:Sucrose
keywords: analgesia; autonomic; crying; grimacing; heart rate; infant; newborn; pacifier; pain; sucrose; vaccination; warmth