title: What is the Best Pain Management During Gastric Tube Insertion for Infants Aged 0-12months: A Systematic Review.
abstract: OBJECTIVE
  Synthesized evidence on the effectiveness of pain management for nasogastric tube (NGT) and orogastric tube (OGT) insertions in infants is lacking. This paper is a systematic review of the effectiveness of pain management for gastric tube (GT) insertion in infants.
  
  
  METHODS
  Randomized control trial (RCT) or quasi-experimental studies published up to April 2016, on pain management strategies during GT insertions (either NGT or OGT) in infants up to 12months of age. Databases searched included seven English databases and three Chinese databases.
  
  
  RESULTS
  Six English studies out of 1236 screened met the eligibility criteria and were included in the review. Two studied OGT insertion and four studies focused on NGT insertion. All six studies evaluated oral sweet solutions (24%-30% sucrose and 25% glucose) compared to placebo (water) or no treatment and all focused on newborn infants. Data from four studies which used the Premature Infant Pain Profile (PIPP) were pooled for meta-analysis. Results showed a significant reduction in PIPP scores during or immediately after the procedure for sweet solution interventions (MD=-2.18, 95% CI (-3.86, -0.51), P=0.01), compared to no intervention or placebo.
  
  
  CONCLUSIONS
  Small volumes of oral sweet solutions reduce pain during GT insertion procedure in newborn infants.
  
  
  CONCLUSIONS
  Oral sweet solutions can be recommended before GT insertion for newborns in clinical practice. Further studies determining the effect of sweet solution beyond the newborn period, different concentrations of sweet solution and comparison with other pain management strategies are warranted. Systematic review registration number: CRD42016038535. http://www.crd.york.ac.uk/prospero/.
authors.affiliation: School of Nursing of Hunan University of Medicine, Huaihua, China.
authors.forename: Shaolin
authors.initials: S
authors.lastname: Chen
authors.affiliation: School of Nursing of Hunan University of Medicine, Huaihua, China.
authors.forename: Qing
authors.initials: Q
authors.lastname: Zhang
authors.affiliation: School of Nursing of Hunan University of Medicine, Huaihua, China; McLaughlin Center for Population Health Risk Assessment, Institute of Population Health, University of Ottawa, Ottawa, Canada.
authors.forename: Ri-Hua
authors.initials: RH
authors.lastname: Xie
authors.affiliation: OMNI Research Group, Department of Obstetrics and Gynecology, University of Ottawa Faculty of Medicine, Canada; The Ottawa Hospital Research Institute Clinical Epidemiology Program, Ottawa, Canada; School of Epidemiology, Public Health, and Preventive Medicine, University of Ottawa Faculty of Medicine, Ottawa, Canada.
authors.forename: Shi Wu
authors.initials: SW
authors.lastname: Wen
authors.affiliation: University of Ottawa and Children's Hospital of Eastern Ontario, Canada. Electronic address: dharrison@cheo.on.ca.
authors.forename: Denise
authors.initials: D
authors.lastname: Harrison
mesh_terms: D000284:Administration, Oral; D004750:Enteral Nutrition / Q000009:adverse effects* / Q000379:methods; D005260:Female; D005947:Glucose / Q000008:administration & dosage; D006801:Humans; D007223:Infant; D008297:Male; D010146:Pain / Q000209:etiology* / Q000503:physiopathology; D059408:Pain Management / Q000379:methods*; D010147:Pain Measurement; D011379:Prognosis; D016032:Randomized Controlled Trials as Topic; D018570:Risk Assessment; D013395:Sucrose / Q000008:administration & dosage; D013549:Sweetening Agents / Q000008:administration & dosage*
chemical_list: D013549:Sweetening Agents; D013395:Sucrose; D005947:Glucose
keywords: Gastric tube; Glucose; Infants; Newborn; Painful procedure; Sucrose; Sweet solution; Systematic review