title: To evaluate and compare the efficacy of combined sucrose and non-nutritive sucking for analgesia in newborns undergoing minor painful procedure: a randomized controlled trial.
abstract: OBJECTIVE
  The objective of this study was to evaluate and compare the efficacy of combined sucrose and non-nutritive sucking (NNS) for analgesia in newborn infants undergoing heel-stick procedures.
  
  
  METHODS
  This randomized control trial was conducted in the neonatal intensive care unit of a tertiary care hospital over a period of 1 year. One hundred and eighty full-term neonates with birth weight >2200 g and age >24 h were randomized to one of four interventions administered 2 min before the procedure: 2 ml of 30% sucrose (group I, n=45) or NNS (group II, n=45) or both (group III, n=45) or none (group IV, n=45). Primary outcome was composite score based on Premature Infant Pain Profile (PIPP) score.
  
  
  RESULTS
  Baseline variables were comparable among the groups. Median (interquartile range) PIPP score was 3 (2 to 4) in group III as compared with 7 (6.5 to 8) in group I, 9 (7 to 11) in group II and 13 (10.5 to 15) in group IV. Group III had significant decrease in the median PIPP score compared with other groups (P=0.000). Median PIPP score also decreased significantly with any intervention as compared with no intervention (P=0.000).
  
  
  CONCLUSIONS
  Sucrose and/or NNS are effective in providing analgesia in full-term neonates undergoing heel-stick procedures, with the combined intervention being more effective compared with any single intervention.
authors.affiliation: Department of Paediatrics, Government Medical College and Hospital, Vadodara, India.
authors.forename: P
authors.initials: P
authors.lastname: Thakkar
authors.affiliation: Division of Neonatology, Department of Paediatrics, Dayanand Medical College and Hospital, Ludhiana, India.
authors.forename: K
authors.initials: K
authors.lastname: Arora
authors.affiliation: Department of Paediatrics, Government Medical College and Hospital, Vadodara, India.
authors.forename: K
authors.initials: K
authors.lastname: Goyal
authors.affiliation: Department of Pediatrics, All India Institute of Medical Sciences, Bhubaneswar, India.
authors.forename: R R
authors.initials: RR
authors.lastname: Das
authors.affiliation: Department of Paediatrics, Government Medical College and Hospital, Vadodara, India.
authors.forename: B
authors.initials: B
authors.lastname: Javadekar
authors.affiliation: Department of Paediatrics, Government Medical College and Hospital, Vadodara, India.
authors.forename: S
authors.initials: S
authors.lastname: Aiyer
authors.affiliation: Department of Community Medicine, IMS and SUM Hospital, Bhubaneswar, India.
authors.forename: S K
authors.initials: SK
authors.lastname: Panigrahi
mesh_terms: D000698:Analgesia / Q000379:methods*; D001800:Blood Specimen Collection; D005260:Female; D006801:Humans; D007194:India; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D008297:Male; D064306:Non-Nutritive Sweeteners / Q000008:administration & dosage*; D010146:Pain / Q000517:prevention & control*; D059408:Pain Management / Q000379:methods*; D010147:Pain Measurement; D013391:Sucking Behavior; D013395:Sucrose / Q000008:administration & dosage*; D047929:Term Birth; D062606:Tertiary Care Centers
chemical_list: D064306:Non-Nutritive Sweeteners; D013395:Sucrose