Format

Send to

Choose Destination
Pediatrics. 2017 Jan;139(1). pii: e20160955. doi: 10.1542/peds.2016-0955. Epub 2016 Dec 16.

Sweet Solutions to Reduce Procedural Pain in Neonates: A Meta-analysis.

Author information

1
Children's Hospital of Eastern Ontario (CHEO) Research Institute, Ottawa, Ontario, Canada; dharrison@cheo.on.ca.
2
School of Nursing, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada.
3
Children's Hospital of Eastern Ontario (CHEO) Research Institute, Ottawa, Ontario, Canada.
4
Departamento Enfermagem Materno-Infantil e Psiquiátrica (ENP), University of São Paulo, São Paulo, Brazil.
5
Institute of Health Economics, Edmonton, Alberta, Canada.
6
Ottawa Hospital Research Institute (OHRI), Ottawa, Ontario, Canada.
7
The Hospital for Sick Children, Toronto, Ontario, Canada; and.
8
Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada.

Abstract

CONTEXT:

Abundant evidence of sweet taste analgesia in neonates exists, yet placebo-controlled trials continue to be conducted.

OBJECTIVE:

To review all trials evaluating sweet solutions for analgesia in neonates and to conduct cumulative meta-analyses (CMAs) on behavioral pain outcomes.

DATA SOURCES:

(1) Data from 2 systematic reviews of sweet solutions for newborns; (2) searches ending 2015 of CINAHL, Medline, Embase, and psychINFO.

DATA EXTRACTION AND ANALYSIS:

Two authors screened studies for inclusion, conducted risk-of-bias ratings, and extracted behavioral outcome data for CMAs. CMA was performed using random effects meta-analysis.

RESULTS:

One hundred and sixty-eight studies were included; 148 (88%) included placebo/no-treatment arms. CMA for crying time included 29 trials (1175 infants). From the fifth trial in 2002, there was a statistically significant reduction in mean cry time for sweet solutions compared with placebo (-27 seconds, 95% confidence interval [CI] -51 to -4). By the final trial, CMA was -23 seconds in favor of sweet solutions (95% CI -29 to -18). CMA for pain scores included 50 trials (3341 infants). Results were in favor of sweet solutions from the second trial (0.5, 95% CI -1 to -0.1). Final results showed a standardized mean difference of -0.9 (95% CI -1.1 to -0.7).

LIMITATIONS:

We were unable to use or obtain data from many studies to include in the CMA.

CONCLUSIONS:

Evidence of sweet taste analgesia in neonates has existed since the first published trials, yet placebo/no-treatment, controlled trials have continued to be conducted. Future neonatal pain studies need to select more ethically responsible control groups.

PMID:
27986905
DOI:
10.1542/peds.2016-0955
[Indexed for MEDLINE]
Free full text

Supplemental Content

Full text links

Icon for HighWire
Loading ...
Support Center