Department of Child Health Evaluative Sciences, Hospital for Sick Children, Toronto, Canada.
Pediatrics. 2010 Nov;126(5):894-902. doi: 10.1542/peds.2010-1593. Epub 2010 Oct 11.
The goal was to review published studies of analgesic effects of sweet solutions, to ascertain areas with sufficient evidence of effectiveness and areas of uncertainty.
Databases searched included Medline, Embase, the Cumulative Index to Nursing and Allied Health Literature database, and PsycINFO, using the terms pain*, infant*, neonat*, newborn*, sucrose, glucose, and alternative sugars. Publications were sorted according to type, year, painful procedure studied, placebo/no-treatment groups, population studied, and country of publication.
A total of 298 relevant unique publications involving human infants were identified; 125 (42%) were primary research studies, of which 116 (93%) were randomized controlled trials. Healthy preterm or term newborns were included in 82 studies (65%), and sick or very low birth weight infants were included in 22 (18%). Most studies included single episodes of painful procedures, with only 3 (2%) conducted over long periods. Procedures investigated most frequently were heel lance (49%), venipuncture (14%), and intramuscular injection (14%). Placebo or no-treatment groups were included in 111 studies (89%); in 103 (93%) of those studies, sweet solutions reduced behavioral responses, compared with placebo/ no treatment.
Clinical equipoise relating to analgesic effects of sweet solutions no longer exists for single episodes of procedures for healthy preterm and term newborn infants. Uncertainties include outcomes after prolonged use of sweet solutions, concomitant use of other analgesics, and effectiveness beyond the newborn period. Future research should focus on addressing these knowledge and research gaps.
综述甜味溶液镇痛效果的已发表研究，明确有效性证据充分的领域和存在不确定性的领域。
检索数据库包括 Medline、Embase、护理学及相关健康文献累积索引数据库和 PsycINFO，使用术语“疼痛*”、“婴儿*”、“新生儿*”、“新生”、“蔗糖”、“葡萄糖”和“替代糖”。根据类型、年份、研究的疼痛程序、安慰剂/无治疗组、研究人群和出版物来源对出版物进行分类。
共确定了 298 项涉及人类婴儿的相关独特出版物；其中 125 项（42%）为原始研究，其中 116 项（93%）为随机对照试验。健康早产儿或足月儿纳入 82 项研究（65%），患病或极低出生体重儿纳入 22 项研究（18%）。大多数研究包括单次疼痛程序，只有 3 项（2%）进行了较长时间的研究。研究中最常调查的程序是足跟穿刺（49%）、静脉穿刺（14%）和肌肉内注射（14%）。111 项研究（89%）纳入了安慰剂或无治疗组；在其中 103 项（93%）研究中，与安慰剂/无治疗相比，甜味溶液减轻了行为反应。
对于健康早产儿和足月儿单次程序，甜味溶液的镇痛效果已不再存在临床不确定性。不确定性包括长期使用甜味溶液的结果、与其他镇痛药物同时使用的情况以及在新生儿期后的有效性。未来的研究应集中在解决这些知识和研究空白上。
