Must be prescribed on the drug chart (as required) or administered under patient group directive Will only be effective if administered orally Recently, the American Academy of Pediatrics cautioned use of sucrose for infant pain management until appropriate dose, mechanisms of action, and long-term effects of this treatment are addressed; sucrose should be viewed as a prescribed medication that must be tracked (Committee on Fetus and Newborn and Section on Anesthesiology and Pain Medicine, 2016). Archives of Pediatric and Adolescent Medicine, 155, 173-180. Sydney: Paediatrics & Child Health Division, The Royal Australasian College of Physicians; 2005. That seems weird. We assessed whether sucrose administration reduces pain-specific brain and spinal cord activity after an acute noxious procedure in newborn infants. Among the non-pharmacological measures for pain control, the most commonly used were breast milk ad libitum during the procedure , sucrose solution (24–25% sucrose) [22, 30,31,32], dextrose solution (50% dextrose) , non-nutritive sucking (NNS) provided in the form of a gloved finger , and audio-stimulation with music (lullabies or repetitive rhythms) . Sucrose reduces composite pain scores by approximately 20% and is most effective when combined with other strategies . enhances parental understanding of pain perception and management for neonates. The calming and pain-relieving effects of sucrose are thought to be mediated by endogenous opioid pathways activated by sweet taste. They are repeatedly administered to almost all children throughout infancy, childhood and adolescence. Pain left unrelieved has been found to lead to long-term consequences such as distress, anxiety, needle fear, parental non-adherence with vaccination administration, and avoidance of medical care. Objectives: Oral sucrose is commonly used to provide analgesia to neonates during painful procedures, such as venepuncture. What is sucrose? Simple physical strategies such as non-nutritive sucking (i.e., pacifier use) and rocking or holding an infant can also lower pain and distress [ 36 ] . For example, sucrose is frequently used for the management of acute post-procedural pain in newborn and young infants, yet the mechanism of sucrose-induced analgesia remains unknown [7, 8]. The additional benefits of reducing pain during venepuncture when oral sucrose is combined with nonpharmacological strategies have not been extensively studied. Careful assessment of pain and distress during procedures is required to evaluate the effectiveness of sucrose analgesia. An optimal dose could not be identified due to inconsistency in effective sucrose dosage among studies.Further investigation on repeated administration of sucrose in neonates and the use of sucrose in combination with oth … In 2001, the American Academy of Pediatrics proposed guidelines for prevention and treatment of neonatal pain, in which nonpharmacological interventions, such as sucrose, NNS, and skin-to-skin contact were recommended in minor painful procedures. The aim of this paper is therefore to review sucrose efficacy beyond the neonatal period to Guideline statement: Management of procedure-related pain in neonates. Finding pain-mitigating interventions that are low-cost, effective, and feasible across all settings, including with low-resourced settings could improve primary healthcare. Neonatal pain is best managed using a multi-directional approach which can be conceptualized in a tiered manner (see Fig. “When sucrose is used as a pain management strategy, it should be prescribed and tracked as a medication. How much Babies do feel pain. The effect may be prolonged by administering 2 or three repeat doses at 2 minute intervals during the procedure. That rant already exists on this blog.It was also the subject of my talk at the final SMACC conference, which is now online.Another blog post is probably unnecessary, but neither resource included the references from my literature review, so for those who are interested, these are my extended notes on the subject. 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