The analgesic potential of different types of sugar solutions in prevention of procedural pain in term infants
Authors:
J. Macko 1; P. Humpolíček 2; D. Moravčíková 3; M. Kotíková 1
Authors place of work:
Novorozenecké oddělení Krajské nemocnice T. Bati, Zlín primář MUDr. J. Macko
1; Centrum polymerních materiálů, Fakulta technologická, Univerzita Tomáše Bati, Zlín vedoucí doc. Ing. R. Čermák, Ph. D.
2; Ústav porodní asistence, Institut zdravotnických studií, Univerzita Tomáše Bati, Zlín vedoucí Mgr. L. Reslerová, Ph. D.
3
Published in the journal:
Čes-slov Pediat 2013; 68 (4): 234-245.
Category:
Original Papers
Summary
Background:
In the prevention of procedural pain in neonates of all gestational categories mainly sugar solutions of different types and concentrations are used. Even though this method studying the effect of sugar solutions in concentrations from 5 to 66% has been certified by series of works, no gold standard has been established. An alternative to the use of sugar solutions is breast milk or sensory saturation (complex effect on sensory perceptions of the child).
Methods:
In the present paper, we evaluated parameters of electrical skin conductance (ESC) in a group of full-term or near-term infants in a well-defined painful complaint, which was capillary blood sampling for mandatory screening.
Results and conclusion:
We evaluated the effectiveness of four different concentrations of sugar solutions, widely available and used in clinical practice. We have shown that there are statistically significant differences between genders in selected parameters of the electrical conductivity of the skin as well as differences in the change of character behavior in response to a painful stimulus. We found statistically significant differences in the analgesic effect of certain types and concentrations of sugar solutions.
Key words:
electrical skin conductance, infants, pain, algesimetry, analgesic effect
Zdroje
1. Melzack R, Wall PD. Pain mechasnism: A new theory. Science 1965; 150: 171–179.
2. Anand KJS, Hickey PR. Pain and its effects in the human neonate and fetus. N Engl J Med 1987; 317 (21): 1321–1329.
3. Lowrey CL, Hardman MP, Manning N, et al. Neurodevelopmental changes of fetal pain. Semin Perinatol 2007; 31: 275–282.
4. Derbyshire SWG, Fitzgerald M. The painful consequences of neonatal nociceptive input. Pain 2010; 150: 220–221.
5. Als H, Duffy FH, McAnulty GB, et al. Early experience alters brain function and structure. Pediatrics 2004; 113: 846–857.
6. Stevens B, McGrath P, Gibbins S, et al. Procedural pain in newborns at risk for neurological impairment. Pain 2003; 105: 27–35.
7. Hudson-Barr D, Capper-Michel B, Lambert S, et al. Validation of the pain assessment in neonates (PAIN) scale with the neonatal infant pain scale (NIPS). Neonatal Netw 2002; 21 (6): 15–21.
8. van Dijk M, deBoer JB, Koot HM, et al. The reliability and validity of the COMFORT scale as postoperative pain instrument in 0 to 3 year old infants. Pain 2000; 84: 367–377.
9. Peters JW, Koot HM, Grunau RE, et al. Neonatal facial coding system for assessing postoperative pain in infants; item reduction is valid and feasible. Clin J Pain 2003; 19: 353–363.
10. Fitzgerald M, Shaw A, MacIntosh. Postnatal development of the cutaneous flexor reflex: Comparative study of preterm infants and newborn rat pups. Dev Med Child Neurol 1991; 30: 520–526.
11. Stevens B, Gibbins S, Franck LS. Treatment of pain in the neonatal intensive care unit. Pediatr Clin N Am 2000; 47 (3): 633–650.
12. Bellieni CV, Bagnoli F, Buonocore G. Alone no more: Pain in premature infants. Ethics Med 2003; 19 (1): 5–10.
13. Chiswick ML. Assessment of pain in neonates. Lancet 2000; 355: 6–8.
14. Anand KJS. The neuroanatomy, neurophysiology, and neurochemistry of pain, stress, and analgesia in newborns and children. Pediatr Clin N Am 1989; 36 (4): 795–822.
15. Smith RP, Gitau R, Glover V, et al. Pain and stress in the human fetus. Eur J Obstet Gynecol Reprod Biol 2000; 92 (1): 161–165.
16. Glover V. The fetus may feel pain from 20 weeks. (The fetal pain controversy.) Conscience 2003; 35 (3), Vol. 25: No. 3. ISSN: 0740-6835.
17. Anand KJS, Hickey PR. Pain and its effects in the human neonate and fetus. N Engl J Med 1987; 317: 1321–1329.
18. Abu-Saad HH, Bours JJW, Stevens B, et al. Assess-ment of pain in the neonate. Semin Perinatol 1998; 22: 402–416.
19. Storm H. Skin conductance and the stress response from heel stisk in preterm infants. Arch Dis Child Fetal Neonatal Ed 2000; 83 (2): F143–F147.
20. Gjerstad AN, Wagner K, Henrichsen T, et al. Skin conductance versus the modified COMFORT sedation score as a measure of discomfort in artificially ventilated children. Pediatrics 2008; 122: e848–e853.
21. Storm H, Shafiei M, Myre K, et al. Palmar skin conductance compared to a developed stress score and to noxious and awakeness stimuli on patiens in anaesthesia to study the sensitivity and specificity of skin conductance. Acta Anaesth Scand 2005; 49: 798–804.
22. Storm H, Skorpen F, Klepstad P, et. al. Genetic variations influence the skin conductance response to nociceptive pain in anesthetized patiens. Abstract accepted ISAP, Orlando; 2008.
23. Edelberg R. Electrical properities of the skin. In: Brown CC (ed). Methods in Psychophysiology. Baltimore, MD: Williams &Wilkins; 1967: 1–53.
24. Hagbarth KE, Halin RG, Hongell A, et al. General characteristics of sympatethic activity in human skin nerves. Acta Physiol Scand 1972; 84 (2): 164–176.
25. Wallin BG, Sundlöf G, Delius W. The effect of karotid sinus nerve stimulations on muscle and skin nerve sympathetic activity in man. Pflugers Arch 1975; 358 (2): 101–110.
26. Gladman G, Chiswick ML. Skin conductance and arousal in the newborn infant. Arch Dis Child 1990; 65: 1063–1066.
27. Macefield VG, Wallin BG. The change in behavior of single sympathetic outflow in normotensive human sweat glands. J Auton Nerv Syst 1996; 14: 277–286.
28. Lindberg L, Wallin G. Sympathetic skin nerve discharges in relation to amplitude of skin resistence response. Psychophysiology 1981; 18 (3): 268–270.
29. Hellerud BC, Storm H. Skin conductance and behaviour during sensory stimulation of preterm and term infants. Early Hum Dev 2006; 70: 35–46.
30. Golianu B, Krane E, Seybold J, et al. Non-pharmagological techniques for pain management for pain in neonates. Semin Perinatol 2007; 31 (5): 318–322.
31. Prechtl HFR. The Neurological Examination of the Full Term Newborn Infant. 2nd ed. London: Lippincott, 1977.
32. Prechtl HFR. The behavioural states of the newborn infant (a review). Brain Res 1974; 76 (2): 185–212.
33. Stevens B, Yamada J, Ohlsson A. Sucrose for analgesia in newborn infants undergoing painful procedures. Cochrane Database Syst Rev 2004;(3):CD 001069.
34. Gibbins S, Stevens B. The influence of gestational age on the efficacy and short-term safety of sucrose for procedural pain relief. Adv Neonatal Care 2003; 3 (5): 241–249.
35. Jonhston CC, Stremler R, Horton L, et al. Effect of repeated doses of sucrose during heel stick procedure in preterm neonates. Biol Neonate 1999; 75 (3): 160–166.
36. Stevens B, Jonhson C, Franck L, et al. The efficacy of developmentally sensitive interventions and sucrose for relieving procedural pain in very low birth weight neonates. Nurs Res 1999; 48 (1): 35–43.
37. Bucher HU, Moser T, Von Siebenthal K, et al. Sucrose reduces pain reaction to heel lancing in preterm infants: Placebo controlled randomized and masked study. Pediatr Res 1995; 38 (3): 332–335.
38. Lindh V, Wicklund U. The role of endigenous opioids in mediating pain reduction by orally administered glucose among newborns. Pediatrics 2005; 115 (4): 1004–1007.
39. Spangler R, Wittkowski KM, Goddard NL. Opiate-like effects of sugar on gene expression in reward areas of the rat brain. Brain Res Mol Brain Res 2004; 124 (2): 134–142.
40. Brase DA, Han YH, Dewey WL. Effects of glucose and diabetes on bindingof naloxone and dihydromorphine to opiate receptors in mouse brain. Diabetes 1987; 36: 1173–1177.
41. Blass EM, Ciaramitaro V. A new look to some old mechanisms in human newborns: taste and tactile determinants of state, affect and action. Monogr Soc Res Child Dev 1994; 59 (1): I–V, 1–81.
42. Woolf CJ, Ma Q. Nociceptors--noxious stimulus detectors. Neuron 2007; 55 (3): 353–364.
43. Colantuoni C, Schwenker J, McCarthy J, et al. Excessive sugar intake alters binding to dopamine and mu-opioid receptors in the brain. Neuroreport 2001; 12: 3549–3552.
44. Cregg R, Momin A, Rugiero F, et al. Pain chanellopathies. J Physiol 2010; 588: 1897–1904.
45. Fields HL, Basbaum AI. Central nervous system mechanisms of pain modulation. In: Wall PD (ed). Textbook of Pain. Churchill Livingstone, 1999: 309–329.
46. Haouari N, Wood C, Griffiths G, et al. The analgesic effect of sucrose in full term iinfants: a randomized controlled trial. BMJ 1995; 310: 1498–1500.
47. Harrison D, Boyce S, Loughnan P, et al. Skin conductance as a measure of pain and stress in hospitalised infants. Early Hum Dev 2008; 82: 603–608.
48. Macko J, a kol. Změny elektrické kožní vodivosti v důsledku bolestivého stimulu u novorozenců různých gestačních kategorií a srovnání se změnami vybraných fyziologických parametrů. Čes-slov Pediat 2011; 66 (6): 363–371.
49. Carbajal R, Chauvet X, Couderc S, Olivier-Martin M. Randomized trial of analgesic effect of sucrose, glucose and pacifiers in term neonates. BMJ 1999; 319: 1393–1397.
50. Riley JL, Robinson ME, Wise EA, Myers CD, Fillingim RB. Sex differencies in the perception of noxious stimuli: a metaanalysis. Pain 1998; 74: 181–187.
51. Gunsburg R, Peres CDA, de Almeida MF, et al. Differences in pain expression between male and female newborn infants. Pain 2000; 85: 127–133.
52. Grunau RVE, Craig KD. Facial activity as a measure of neonatal pain expression. Adv Pain Res 1990; 5: 147–156.
53. Macko J, a kol. Procedurální bolest novorozence – možnosti prevence a tišení. Čes-slov Pediat 2010; 65 (10): 584–591.
54. Rokyta R. Fetal pain. Neuroendocrinology Letters 2008; 29 (6): 807–814.
55. Rokyta R, Fricová J. Ontogeny of the pain. Physiol Res 2012; 61 (Suppl 1): 109–122.
Štítky
Neonatology Paediatrics General practitioner for children and adolescentsČlánok vyšiel v časopise
Czech-Slovak Pediatrics
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