Purpose
This study compared the pain-relieving effects of human milk, sucrose, and distilled water during examinations for retinopathy of prematurity.
Methods
Forty-five preterm infants were randomly assigned to receive a pacifier dipped in one of three solutions: human milk (n=14), 24% sucrose (n=15), or distilled water (n=16), 2 minutes before an eye examination. Their pain score, pulse rate, and oxygen saturation were measured at three time points: 5 minutes before the examination, 30 seconds after speculum introduction, and 2 minutes after the examination.
Results
The infants’ mean gestational age and weight at birth were 33.1±2.1 weeks and 1,842±470 g, respectively. There were no between-group differences in pain relief during the eye examination. The pain score significantly increased both during (p<.001) and after the examinations (p=.003). Oxygen saturation decreased during the examinations (p<.001); however, the infants in the 24% sucrose group showed higher oxygen saturation (p=.047) during the examinations than the infants in the other groups.
Conclusion
Sucking on a pacifier dipped in human milk or 24% sucrose did not reduce the pain associated with eye examinations in preterm infants. Pacifiers dipped in sucrose can be used to maintain better oxygen saturation during these examinations.

Citations

• Effects of fentanyl and sucrose on pain in retinopathy examinations with pain scale, near-infrared spectroscopy, and ultrasonography: a randomized trial
  Nursu Kara, Didem Arman, Zeynep Seymen, Adem Gül, Serdar Cömert
  World Journal of Pediatrics.2023; 19(9): 873.     CrossRef
• Non-pharmacological pain relief interventions in preterm neonates undergoing screening for retinopathy of prematurity: a systematic review
  Iretiola Bamikeolu Fajolu, Iyabode Olabisi Florence Dedeke, Beatrice Nkolika Ezenwa, Veronica Chinyere Ezeaka
  BMJ Open Ophthalmology.2023; 8(1): e001271.     CrossRef
• Effect of non-nutritive sucking on pain during the examination of retinopathy of prematurity
  Tuba Koç Özkan, Elif Didem Yüksel, Selahattin Akar
  Journal of Neonatal Nursing.2022; 28(3): 155.     CrossRef
• Effect of Prone Position, Pacifier and Smelling Breast Milk on Pain and Stress Parameters Among Term Neonates Undergoing Venipuncture: A Randomized Controlled Trail
  Fuat Özdemir, Derya Evgin, Nalan Gördeles Beşer
  The Journal of Pediatric Research.2022; 9(2): 146.     CrossRef
• Effectiveness of Gentle Human Touch for Pain Control During Examination for Retinopathy of Pre-maturity: A Randomized Controlled Trial
  Yongping Sun, Jinghan Zhang, Xu Chen, Yang Yang, Jie Qiu, Ke-yu Lu, Rui Cheng
  Frontiers in Pediatrics.2020;[Epub]     CrossRef

PURPOSE
This study is to assess and compare the analgegic effects of 25% sucrose coating pacifier and pacifier.
METHOD
The participants are 75 healthy infants of neonatal age 1-7 days and randomized to receive heel prick before 2 minutes to blood sampling and physiological test in Nursery of A Medical Center from 24, January to 28, February, 2003. The experimental group assigned to one of three treatment groups: no treatment, a pacifier, 25% sucrose coating pacifier. Collected data were analyzed with the SPSS 11.0 program using Chi square-test, one-way ANOVA and Scheffe, repeated mesured ANOVA. RESULTS: The pain score of 25% sucrose coating pacifier is lower than no treatment group and pacifier group. In heart rate, there were statistical significant differences between three groups. In repiratory rate, there were no statistical significant differences between three groups. In SaO2, there were statistical significant difference between three groups. CONCLUSION: The 25% sucrose coating pacifier showed pain relief effect in behavior responses and heart rate and SaO2. Accordingly, the sucrose coating pacifier should be applied nursing intervention for simple pain management as heel prick.

The ability of neonates to perceive and react to pain, has been acknowledged recently. Recent researches have been shown that even short term pain can have lasting negative effects. We know that most of the anatomical pathway and neurotransmitter function necessary for pain perception are fully or nearly fully developed in the neonatal period. Many people are still reluctant to believe that pain felt by neonates may be as severe as that felt by older children or adults yet. The objective of the study is to assess and compare the analgesic effects of orally administered sucrose and pacifiers. And to determine the synergistic analgesic effects of sucrose and pacifiers. The tools for this study is Lawrence's NIPS (neonatal infant pain scale) with behavioural pain responses and index for pain physiological reponses as heart rate, respiratory rate and degree of SaO2. The participants are 96 healthy infants of neonatal age 1-7days and randomised to receive heel prick before 2minutes to blood sampling and physiological test in Nursery of K Medical University Hospital on May-July, 2000. The experimental group assigned to one of three treatment groups : no treatment; a pacifier; placebo(2ml 25% sucrose). Collected data were analyzed with the SAS program using X2-test, ANOVA and Duncan's multiple range test as post hoc. The results were as follows. 1) Pain behaviour responses: The pain score of placebo group(2ml 25% sucrose) is lower than no treatment group and pacifier group significantly(P=.000). Placebo group is different from no treatment and pacifier group with Duncan's multiple range test. 2) Pain physiologic responses (1) heart rate: The heart rate of placebo group(2ml 25% sucrose) is different from that of no treatment group and pacifier group significantly(P=.000). The heart rate change of placebo group is less than the other groups. (2) respiratory rate: The respiratory rate of placebo group(2ml 25% sucrose) is different from that of no treatment group and pacifier group insignificantly (P=.2340). But, the respiratory rate of placebo group is lower than the other groups. (3) SaO2: The SaO2 score of placebo group(2ml 25% sucrose) is different from that of no treatment group and pacifier group insignificantly (P=.3265). But, the change of SaO2 score of placebo group is less than the other groups. In conclusion, the sucrose placebo showed pain relief effect in behavior responses and less physiological responses. Accordingly, the sucrose placebo should be applied nursing intervention for simple pain management as heel prick.