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Eur J Pediatr Surg 2021; 31(05): 439-444
DOI: 10.1055/s-0040-1716883
Original Article

Effects of Sucrose and Nonnutritive Sucking on Pain Behavior in Neonates and Infants undergoing Wound Dressing after Surgery: A Randomized Controlled Trial

Sahatsa Mandee 
1   Department of Anesthesiology, Faculty of Medicine, Mahidol University, Siriraj Hospital, Bangkok, Thailand
,
Kusuma Buachai
1   Department of Anesthesiology, Faculty of Medicine, Mahidol University, Siriraj Hospital, Bangkok, Thailand
,
Naiyana Aroonpruksakul
1   Department of Anesthesiology, Faculty of Medicine, Mahidol University, Siriraj Hospital, Bangkok, Thailand
,
Niramol Tantemsapya
2   Department of Surgery, Faculty of Medicine, Mahidol University, Siriraj Hospital, Bangkok, Thailand
,
Tarinee Buasuk
1   Department of Anesthesiology, Faculty of Medicine, Mahidol University, Siriraj Hospital, Bangkok, Thailand
› Author Affiliations Funding This research project was supported by Siriraj Research Development Fund, Faculty of Medicine, Siriraj Hospital, Mahidol University (grant number [IO] R016131014). The funders had no role in study design, data collection, analysis, and preparation of the manuscript.
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Abstract

Introduction Wound dressing, a procedure that pediatric patients are commonly exposed to postoperatively, can cause strong physiological and pain behavioral responses despite being brief. This study evaluated the effects of using 24% sucrose plus a pacifier versus a pacifier alone to reduce the pain response from dressing wounds in neonates and infants.

Materials and Methods Thirty-two neonates and infants who underwent surgery and required postoperative wound dressing were randomized to a pacifier group (n = 16) and a 24% sucrose plus pacifier group (“sucrose group”; n = 16). Demographic data, crying time, and pain behaviors were recorded using a video recorder. The pain behaviors were assessed independently using the neonatal infant pain scale (NIPS) by three assessors, who were expert in pediatric pain assessment and blinded to the subject allocations.

Results Participants in the sucrose group were older than those in the pacifier group (6.19 ± 2.95 vs. 3.88 ± 3.2 months). While there were no differences in the NIPS scores of the two groups at 30, 120, and 240 seconds, the incidence of moderate-to-severe pain was lower in the sucrose group than the pacifier group at 120 seconds (37.5 vs. 50%). The crying time was lower in the sucrose group, but without statistical significance.

Conclusion The 24% sucrose plus pacifier was not superior to the pacifier alone in decreasing pain behavioral responses. Dressing wound pain produced a high-intensity pain behavioral response. A pain management strategy should be developed to lessen the postoperative procedural pain in pediatric patients.

Keywords

neonatal pain - infant pain - sucrose - nonnutritive sucking - wound dressing

Authors' Contributions

S.M. conceptualized the questionnaire, approved the final manuscript as submitted, conceptualized and designed the study, agree to be accountable for all aspects of the work, and drafted the initial manuscript. K.B. acquired the data and drafted the initial manuscript. N.A. approved the final manuscript as submitted and drafted the initial manuscript. N.T. approved the final manuscript as submitted and drafted the initial manuscript. T.B. acquired the data and drafted the initial manuscript.




Publication History

Received: 05 June 2020

Accepted: 16 August 2020

Article published online:
17 September 2020

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