School of Nursing, Federal University of Minas Gerais, Belo Horizonte, Brazil.
Pain Res Manag. 2013 May-Jun;18(3):153-61. doi: 10.1155/2013/956549.
Sucrose has been demonstrated to provide analgesia for minor painful procedures in infants. However, results of trials investigating other sweet solutions for neonatal pain relief have not yet been synthesized.
To establish the efficacy of nonsucrose sweet-tasting solutions for pain relief during painful procedures in neonates.
The present article is a systematic review and meta-analyses of the literature. Standard methods of the Cochrane Neonatal Collaborative Review Group were used. Literature searches were reviewed for randomized controlled trials investigating the use of sweet solutions, except sucrose, for procedural pain management in neonates. Outcomes assessed included validated pain measures and behavioural and physiological indicators.
Thirty-eight studies (3785 neonates) were included, 35 of which investigated glucose. Heel lancing was performed in 21⁄38 studies and venipuncture in 11⁄38 studies. A 3.6-point reduction in Premature Infant Pain Profile scores during heel lances was observed in studies comparing 20% to 30% glucose with no intervention (two studies, 124 neonates; mean difference -3.6 [95% CI -4.6 to -2.6]; P<0.001; I2=54%). A significant reduction in the incidence of cry after venipuncture for infants receiving 25% to 30% glucose versus water or no intervention was observed (three studies, 130 infants; risk difference -0.18 [95% CI -0.31 to -0.05]; P=0.008, number needed to treat = 6 [95% CI 3 to 20]; I2=63%).
The present systematic review and meta-analyses demonstrate that glucose reduces pain scores and crying during single heel lances and venipunctures. Results indicate that 20% to 30% glucose solutions have analgesic effects and can be recommended as an alternative to sucrose for procedural pain reduction in healthy term and preterm neonates.
蔗糖已被证明可减轻婴儿轻微疼痛操作的疼痛。然而，尚未综合评估其他用于新生儿疼痛缓解的甜味溶液的试验结果。
确定非蔗糖甜味溶液在减轻新生儿疼痛操作时的疗效。
本研究是对文献的系统评价和荟萃分析。采用 Cochrane 新生儿协作组的标准方法。检索文献以调查除蔗糖以外的甜味溶液在新生儿程序性疼痛管理中的应用的随机对照试验。评估的结果包括验证疼痛测量指标以及行为和生理指标。
共纳入 38 项研究（3785 例新生儿），其中 35 项研究涉及葡萄糖。21/38 项研究中进行了足跟穿刺，11/38 项研究中进行了静脉穿刺。与无干预相比，在比较 20%至 30%葡萄糖与无干预的足跟穿刺研究中，早产儿疼痛评估量表（Premature Infant Pain Profile scores）评分降低了 3.6 分（两项研究，124 例新生儿；平均差值-3.6 [95% CI -4.6 至 -2.6]；P<0.001；I2=54%）。与接受水或无干预的婴儿相比，接受 25%至 30%葡萄糖的婴儿在静脉穿刺后哭泣的发生率显著降低（三项研究，130 例婴儿；风险差异-0.18 [95% CI -0.31 至 -0.05]；P=0.008，需要治疗的人数=6 [95% CI 3 至 20]；I2=63%）。
本系统评价和荟萃分析表明，葡萄糖可降低单次足跟穿刺和静脉穿刺时的疼痛评分和哭泣。结果表明，20%至 30%的葡萄糖溶液具有镇痛作用，可作为蔗糖的替代品，用于健康足月和早产儿的程序性疼痛缓解。
