Taddio Anna, Shah Vibhuti, Katz Joel
University of Toronto, Leslie Dan Faculty of Pharmacy, Toronto, Ontario, Canada.
Pediatrics. 2009 Mar;123(3):e425-9. doi: 10.1542/peds.2008-3028.
Sucrose has analgesic and calming effects in newborns. To date, it is not known whether the beneficial effects extend to caregiving procedures that are performed after painful procedures. Our objective was to determine the effect of sucrose analgesia for procedural pain on infant pain responses during a subsequent caregiving procedure.
We conducted a double-blind, randomized, controlled trial. Healthy neonates within 2 strata (normal infants and infants of diabetic mothers) were randomly assigned to a sucrose or placebo water group before all needle procedures after birth. Pain response during a diaper change performed after venipuncture for the newborn screening test was determined by using a validated multidimensional measure, the Premature Infant Pain Profile.
The study was conducted between September 15, 2003, and July 27, 2004. Altogether, 412 parents were approached; 263 consented. Twenty-three infants were not assigned, leaving 240 for participation (n = 120 per group), with an equal number in each infant strata. Of those, 186 (78%) completed the study. There were no significant differences in birth characteristics between groups. During diaper change, sucrose-treated infants had lower pain scores than placebo-treated infants. The relative risk of having pain, defined as a Premature Infant Pain Profile score of >/=6, was 0.64 with sucrose compared with placebo.
This study demonstrates that when used to manage pain, sucrose reduces the pain response to a subsequent routine caregiving procedure. Therefore, the benefits of sucrose analgesia extend beyond the painful event to other aversive and potentially painful procedures.
蔗糖对新生儿有镇痛和平静作用。迄今为止，尚不清楚这些有益作用是否能延伸至疼痛操作之后进行的护理程序。我们的目的是确定程序性疼痛的蔗糖镇痛对后续护理程序中婴儿疼痛反应的影响。
我们进行了一项双盲、随机、对照试验。将两个分层（正常婴儿和糖尿病母亲的婴儿）内的健康新生儿在出生后所有针刺操作前随机分配至蔗糖组或安慰剂水组。通过使用经过验证的多维度测量工具——早产儿疼痛量表，来确定新生儿筛查试验静脉穿刺后更换尿布期间的疼痛反应。
该研究于2003年9月15日至2004年7月27日进行。总共联系了412名家长；263名同意参与。23名婴儿未被分配，剩余240名参与研究（每组n = 120），每个婴儿分层中的人数相等。其中，186名（78%）完成了研究。两组之间的出生特征无显著差异。在更换尿布期间，蔗糖治疗组婴儿的疼痛评分低于安慰剂治疗组婴儿。与安慰剂相比，蔗糖治疗组婴儿出现疼痛（定义为早产儿疼痛量表评分≥6）的相对风险为0.64。
本研究表明，当用于管理疼痛时，蔗糖可降低对后续常规护理程序的疼痛反应。因此，蔗糖镇痛的益处不仅限于疼痛事件，还延伸至其他厌恶和潜在疼痛的程序。
