Aim

Neonates feel pain as intensely as adults.  Oral Sucrose has been shown to be an effective and safe treatment for reducing the pain response of neonates.  A neonatal admission will typically involve between 2 and several hundred painful procedures.  The aim is to reduce the discomfort caused by these procedures.

Criteria

Prior to any invasive procedure consideration should be made on how to minimize any resulting pain.  Painful procedures include but are not limited to venepuncture, peripheral venous line placement, heel prick, arterial stab, and peripheral arterial line placement.  Ways to reduce pain can be through the use of pharmacological and non-pharmacological measures.  Non pharmacological measures include ensuring, where possible, that the baby is calm, relaxed, warm, fed and that all necessary equipment for the procedure is at hand.  Once non-pharmacological measures have been implemented, oral sucrose analgesia may be used in babies in Level II NICU and the Parent Infant Nursery.  Oral sucrose will not always eliminate all crying, but is known to significantly reduce the physiological stress of pain.

Administration

• Dose:  0.2ml of a 66.7% Sucrose Solution (Syrup BP, 0.667g/ml).
• No more than 4 oral sucrose doses are to be administered in any 24 hour period.
• There is no minimum interval time between doses of oral sucrose.

Contraindications

• Neonates with known fructose intolerance.
• Neonates <1500g and <31 weeks postconceptional age.
• Lack of parental consent.

Supporting Information

• Parents should be advised that this procedure is to be used in hospital only. An information leaflet is available.
• Consent is no longer required but information should be given to parents about the use of sucrose, and this should be documented on the nursing care map.

Storage

• Oral Sucrose Solution (Syrup BP) should be stored in the refrigerator and discarded one week after the bottle has been opened.

References