Pain
Conditions
Keywords
Sucrose, Effectiveness, Healthcare Delivery, Neonates, Nursing
Brief summary
Recent studies show that babies in hospital undergo an average of 4 to 5 painful procedures, such as heel lances, every day. Sucrose (sugar water) has been shown to be effective for reducing babies' pain during painful procedures. Unfortunately, sucrose is not used as often as it could be to reduce babies' pain. This may be due to lack of certainty about the least effective amount of sucrose to use and concerns about the long-term effects of repeated use of sucrose on infant development. Factors within the hospital units where babies receive care may also influence caregivers' decisions to use sucrose. In this research the investigators will conduct two main studies. In the first study the investigators determined the lowest amount of sucrose needed to manage babies' pain effectively. In the second study the investigators will explore (a) if this amount of sucrose can manage pain when it is used repeatedly for all painful procedures while the baby is hospitalized and (b) whether consistent use of sucrose influences the development of babies when they are 18 and 36 months old. During the second study, the investigators will also examine the hospital units where the babies receive care. They will look at staff support for research, time and resources and other factors that promote and prevent sucrose use. The results of these studies will be used to determine the best management of babies' pain during painful procedures in hospitals to achieve the best outcomes.
Interventions
OTHER24% Sucrose Solution
Two minutes prior to the start of a painful procedure neonates will receive 0.12ml of 24% sucrose solution, over a period of no more than 1 minute. A pacifier will be offered immediately following sucrose administration for non-nutritive sucking if the infant is able to hold the pacifier securely. The sucrose study dose is to be repeated as needed based on pain response and procedure duration.
Sponsors
Sunnybrook Health Sciences Centre
IWK Health Centre
The Ottawa Hospital
Children's Hospital of Eastern Ontario
The Hospital for Sick Children
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
SUPPORTIVE_CARE
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
No minimum to 10 Days
Healthy volunteers
No
Inclusion criteria
Inclusion: * less than 32 weeks gestational age at birth * admitted to the neonatal intensive care unit (NICU) * expected to have heel lances for routine blood tests * yet to reach 10 days of life at the time of study enrollment. Exclusion: * known hypersensitivity to sucrose, corn, corn products or any component of the formulation * short-bowel syndrome * carbohydrate intolerance * unable to swallow/absent gag reflex (e.g., pharmacologically muscle relaxed, unconscious, or heavily sedated)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Pain intensity | Measured 30 seconds post-painful procedure. (NB: Enrolled infants may be evaluated for multiple painful procedures.) | Assessed by the Premature Infant Pain Profile - Revised (PIPP-R) |
| Neurodevelopment (cognitive, language and motor development) | 18 months corrected gestational age | Assessed by the Bayley Scales of Infant and Toddler Development (BSITD-III) |
| Neurodevelopment (social-emotional functioning) | 36 months corrected gestational age | Assessed by the Ages & Stages Questionnaires: Social-Emotional, Second Edition (ASQ:SE-2) |
| Neurodevelopment (vision, hearing, speech, emotion, dexterity, self-care, cognition, pain, general health and behaviour) | 36 months corrected gestational age | Assessed by the Health Status Classification System-Preschool (HSCS-PS) |
Countries
Canada
Outcome results
None listed