RCT to Assess the Effectiveness of 24% Oral Sucrose Solution (OSS) versus Expressed Breast Milk (EBM) in the Management of Neonatal Pain

Abstract

Despite, a growing body of knowledge about the physiology of neonatal pain, the evolution of neonatal pain assessment tools, and pain management guidelines, there persist  a wide variety of opinions among health care providers about how to treat pain in the neonates. Newborns feel pain and require the same level of pain assessment and management as adults. Scientific research in recent years has continued to confirm that neonates, especially when preterm, are more sensitive to nociceptive stimuli than older children. Adequate pain prevention and management should be an essential part of standard health care at the hospital, and recognizing and assessing sources of pain should be routine in the day-to-day practice of physicians and nurses taking care of the newborn. Currently, all published studies address the effectiveness of sucrose only during heel sticks and venipunctures. Preterm infants undergo a variety of painful procedures on a daily basis, and the effectiveness of oral sucrose during more complex or prolonged procedures needs to be examined. The primary objective of the study was to compare the pain of neonates, who are administered 24% oral sucrose solution (OSS) and expressed breast milk (EBM) during, and at 2 min after the procedure. Thirty neonates each in experimental and control group were randomly allocated to receive 24% OSS or EBM respectively before hepatitis B vaccination. Neonatal pain, heart rate, oxygen saturation and duration of cry was compared before, during and two minutes after the vaccination. The data collected was analyzed using descriptive and inferential statistics. Both the groups were homogeneous with regard to the demographic variables. There was no difference in the baseline heart rate and oxygen saturation of the neonates. There was a significant difference in the posttreatment pain score between both the groups. The pain level was less in 24% OSS group during and at 2 min after the procedure as compared to neonates in EBM group. There was no significant difference in the posttreatment heart rate but a significant difference in the oxygen saturation during the procedure, and at 2 min, in both groups. It was evident that oxygen saturation decreases during the pain. There was significant difference in duration of cry during the procedure in both the groups. Duration of cry was less in 24% OSS group as compared to EBM group. Twenty-four percent OSS is more effective than EBM in reducing the neonatal pain related to hepatitis B vaccination.