Pain Management

Hospitalized Infants Who

Hurt: A Sweet Solution With
Oral Sucrose
Tracy Ann Pasek, RN, MSN, CCRN, CIMI
Jessica Marie Huber, RN, MSN, CCRN

Pain is harmful to newborn infants. Oral sucrose is safe, inexpensive, and effective at preventing and reducing pain in hospitalized babies who undergo invasive
procedures. The sugar can be used alone or in combination with analgesics and
other nonpharmacological interventions to provide analgesia. Parents expect nurses
to serve as pain advocates for the parents newborns and to protect the babies from
needless suffering. It is incumbent upon nurses to stay abreast of the current evidence
and integrate use of oral sucrose into daily pain management practice in emergency,
acute, and critical care units. (Critical Care Nurse. 2012;32[1]:61-69)

ewborn infants who

are sick experience
multiple invasive and
tissue-damaging procedures in emergency,
acute, and critical care units. These
procedures (eg, lancing the heel,
suctioning an endotracheal tube)
are presumed to be painful and
occur during the early days of life
as part of stabilizing, diagnosing,
and treating a babys condition.
Although neonates are capable of
mounting powerful physiological,
behavioral, hormonal, and metabolic responses to nociceptive stimuli, these responses can be harmful
to an infants behavioral and neurological development.1,2 Evidence
2012 American Association of CriticalCare Nurses doi: 10.4037/ccn2012912

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indicates that early and repeated

exposure to pain leads to adverse
neurological outcomes, yet babies in
neonatal intensive care have a mean
of 16 painful procedures a day, the
majority of which are performed
with inadequate analgesia and comfort measures.2-4
Infants, including preterm babies,
for whom intravenous opioid analgesics are not indicated, usually are
given no pain reliever or comfort
measure for routine minor painful
procedures.5 Examples of these
patients include a neonate whose
critical condition is improving after
surgery, a baby who is being evaluated for sepsis in the emergency
department, and an infant with
nonaccidental trauma who is being
transferred from the pediatric intensive care unit to an acute care unit.

In this article, we provide an

overview of oral sucrose analgesia
for infants. The administration of
oral sucrose, with or without nonnutritive sucking (NNS), has been
the most frequently studied nonpharmacological intervention for
relief of procedural pain in neonates.6
Oral sucrose has a beneficial role in
pain prevention and management
for infants, including babies in the
emergency department.7,8 Although
most research on oral sucrose has
been conducted in newborn nurseries and neonatal intensive care
units (NICUs), we present 2 case
reports that illustrate use of oral
sucrose in pediatric and cardiac
intensive care units and the variable
responses of the patients.

Deleterious Effects of Pain

for Newborn Infants
Painful procedures place a newborn at risk for brain damage.9-11
Moreover, brain damage and generation of free radicals are associated
with hypoxia.9 Rapidly developing
tissues in a newborn, such as the
lipid-rich brain, are particularly
susceptible to damage from free

CriticalCareNurse Vol 32, No. 1, FEBRUARY 2012 61

infants wellbeing rather

than solely surArterial puncture, peripheral arterial cutdown
Increased arterial pressure
vival, and
Venipuncture,
peripheral
venous
cutdown
increased
moral
Increased intracranial pressure
Heel
lance
urgency in proOxygen desaturation
Lumbar
puncture
viding
analgesia
Brain damage
have been
Umbilical catheter insertion
Chronic lung disease
described as
Peripherally inserted central catheter placement
Retinopathy of prematurity
ethical changes
Bladder catheterization
Necrotizing enterocolitis
that
may result
Suprapubic bladder tap
Periventricular leukomalacia
in effective pain
Adhesive tape removal
Altered development
control for
Suture removal
Abnormal sensitivity to pain
infants and
Ventricular tap
babies.23,24
Central catheter insertion/removal
Oral sucrose
radicals.9-20 The destructive interplay
Chest tube insertion/removal
is
a
valuable
of pain, hypoxia, and toxic effects
Nasogastric/orogastric tube placement
analgesic option
caused by free radicals leads to poor
Feeding tube placement
for neonates
outcomes. Table 1 lists conditions
Dressing changes
undergoing
of newborns that are associated
9-20
Percutaneous
intravenous
cannulation
brief procedural
with these effects. Nurses must
Screening eye examination for retinopathy of prematurity
pain.25 It has a
consider the long-term deleterious
rapid onset of
Intramuscular injections of vitamin K
effects of repeated unmanaged pain
effects and
Endotracheal tube suctioning
for patients in the NICU, including
9
b
short-lived
preterm babies. Table 2 lists several
Immunizations
action, thought
routine invasive and painful procea Based on information from Anand et al.
b Although immunizations are normally associated with well babies and primary
to be mediated
dures infants must undergo during
care, the procedures are done in the hospital and therefore are included.
by the release of
hospitalization. Of these, the heel
endogenous
lance is the most common painful
brain opioids. Use of the sugar is low
insertion of central catheters. Eight
procedure in NICUs.21
risk and it is simple to administer.
years later, Bellieni and Buonocore23
Moreover, this intervention requires
reported a 30% increase in pain
Standard of Care
22
minimal
time from busy nurses.
management
for
similar
procedures.
A report published in 2000
This increase is an improvement,
revealed that only 5% of neonatal
Description and Forms of
albeit
an unsatisfactory one, in pain
units routinely used analgesia for
Oral Sucrose
management. Full attention to
commonly performed painful proSucrose is a disaccharide combabies
personhood,
promotion
of
cedures such as venipuncture and
posed of a-glucose and fructose in
a 1:1 ratio.26 It is obtained commerAuthors
cially from sugarcane, sugar beets
Tracy Ann Pasek is an advanced practice nurse in the pediatric intensive care unit at Childrens
(Beta
vulgaris), and other plants.27
Hospital of Pittsburgh, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
Commonly known as table sugar,
Jessica Marie Huber is a staff nurse in the pediatric intensive care unit at Childrens Hospital
sucrose is a fine, white, crystallized
of Pittsburgh.
odorless substance used extensively
Corresponding author: Tracy Ann Pasek, RN, MSN, CCRN, CIMI, Advanced Practice Nurse, Pain/PICU, Childrens
Hospital of Pittsburgh of UPMC, One Childrens Hospital Dr, 4401 Penn Ave, Pittsburgh, PA 15224 (e-mail:
as a food and sweetener. Table 3 lists
Tracy.Pasek@chp.edu).
descriptions of oral sucrose in the
To purchase electronic or print reprints, contact The InnoVision Group, 101 Columbia, Aliso Viejo, CA 92656.
literature. The terms are relatively
Phone, (800) 899-1712 or (949) 362-2050 (ext 532); fax, (949) 362-2049; e-mail, reprints@aacn.org.

Table 1

Conditions of newborns
associated with toxic effects of free
radicals

Table 2

Invasive and painful procedures experienced by

hospitalized infantsa

21

62 CriticalCareNurse Vol 32, No. 1, FEBRUARY 2012

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sucrose preparations are produced

in the United States28,29 (Table 4).
Ninety-one percent of the centers
that participated in a neonatal
intensive care quality improvement
collaborative of 12 NICUs chose
Sweet-Ease (a prepackaged 11-mL
container).30 For the purpose of our
article, sucrose for infant analgesia
is referred to as oral sucrose.

Table 3

Terms used for oral

sucrose in published reports
Oral sucrose
Oral glucose
Lingual sucrose
Oral dextrose
Oral sucrose analgesia
Sugar solution analgesia
A sweet pacifier
A sucrose pacifier

Research on Oral Sucrose

synonymous for the same solution
and intent for use. The last 2 descriptions convey NNS more clearly
because of the reference to a pacifier.
When nurses evaluate the evidence,
they should not discount studies
that describe oral glucose as an
intervention, because glucose is a
component of sucrose.
Oral sucrose is a solution of water
and sucrose. Two commercial oral

Table 4

The analgesic effects of sucrose

are not entirely understood. The
mechanism of action is thought to
involve activation of the endogenous opioid system (the release of
b-endorphins) through gustatory
pathways or taste.31,32 A preabsorptive mechanism for sucrose-induced
analgesia is supported by data on its
pain-relieving effects after direct
application to the tongue but not
after administration into the

stomach via a nasogastric tube.31,33

Opioid receptors are present on the
tongue, and studies in animals have
revealed analgesia reversal by opioid antagonists during noxious
stimulation.32 Conversely, findings
from 3 recent studies31,34,35 tend to
refute the possibility of an endogenous opioidmediated mechanism
of effect of oral sucrose or a sweet
solution. Taddio et al31 found no
significant difference in the serum
concentrations of b-endorphins
among preterm infants before and
after a single dose of sucrose.
Specifically, the authors31 found no
detectable increase in the serum
levels of the endorphins at the time
the analgesic effects of sucrose were
anticipated. Opioid tolerance was
not observed in a study in which
infants received repeated doses of
glucose.34 Finally, Gradin and
Schollin35 found that intravenous

Commercial oral sucrose products

Products
Sweet-Ease
http://sweetease.respironics.com

Manufacturer

Packaging

Preservative-free

Preservative

Product safety
Packaging

Wide-based cups Sweet-Ease

Philips Childrens
with peel-back lid Natural
Medical Ventures,
Monroeville,
Directions on foil No preservatives
Pennsylvania
or artificial
lid in English,
ingredients
Spanish, and
French

Hot filling by a
Food and Drug
Administration
registered food
processing
facility

Single patient use

1-year shelf life

Stability at room
temperature
TootSweet
http://www.natus.com

Natus Medical
Incorporated,
San Carlos,
California

Twist-tip vials
Wide-based cups
with peel-back lid
Single patient use

Methylparaben
and potassium
sorbate

Packaging
Fulfillment of an
antimicrobial
preservative
effectiveness test
Guarantee of a
mold- and
bacteria-free
solution
2-year shelf life
(cups and vials)

www.ccnonline.org

CriticalCareNurse Vol 32, No. 1, FEBRUARY 2012 63

the administration of oral

sucrose to
Cry, requirement for increased oxygen administration, increase in
infants more
vital signs, expression, and sleeplessness (CRIES) assessment
than 32 weeks
Neonatal Facial Coding System (NFCS)
gestational age
Neonatal Infant Pain Scale (NIPS)
may be judiNeonatal Pain, Agitation, and Sedation Scale (N-PASS)
cious because
Premature Infant Pain Profile (PIPP)
of possible
Face, legs, activity, cry, consolability (FLACC) pain assessment scale
adverse effects.
Douleur Aigue Nouveau-n (DAN) pain assessment scale
Johnston40
described posUniversity of Wisconsin Childrens Hospital (UWCH) Pain Scale
sible long-term
adverse effects
injection of an opioid antagonist
associated with the administration
did not diminish the analgesic effects
of a 24% solution of oral sucrose to
of orally administered glucose given
infants less than 31 weeks postconbefore blood-sample procedures
ceptional age. Infants who received
among newborn infants. Table 5
high numbers of doses scored lower
summarizes the infant pain assessthan infants who received fewer
ment scales that have been used in
doses on components of the Neuthe research on oral sucrose.
robehavioral Assessment of the
The appropriate group of patients
Preterm Infant. In addition, babies
for sucrose analgesia continues to
who received more doses of oral
be defined. Evidence36 supports the
sucrose had higher Neurobiologic
efficacy of sucrose, with or without
Risk Scores at 2 weeks postnatal
NNS, as a nonpharmacological painage, but they did not have higher
relieving intervention for minor proscores at discharge.
cedural pain in healthy full-term
During 54 glucose interventions
infants. Although NNS reduces pain
(0.3 mL of a 30% oral glucose solubehaviors and heart rate in response
tion) that were administered to
to heel lance, the addition of oral
neonates during subcutaneous injecsucrose may result in a superior
tions, 7 of the babies experienced
analgesic effect.36 Weaknesses in the
slight (85%-88%) and transient oxymethods used in some studies congen desaturations.41 Five neonates
tribute to the obscurity of the distinct
experienced oxygen desaturations
benefits of oral sucrose in preterm
during the administration of glucose
or sick infants.36 Sucrose has analonly, whereas 2 experienced oxygen
gesic effects in infants as young as
desaturations during the administra25 weeks gestation, and most of the
tion of glucose and a pacifier.41 These
medical centers in a neonatal pain
findings contrast the absence of oxycollaborative study used sucrose in
gen desaturations associated with
very low-birth-weight infants.33,37-39
24 administrations of placebo.41
Despite the demonstration of
Infants (27-31 weeks gestational
the effectiveness of oral sucrose in
age) who received a 24% solution of
very low-birth-weight infants, some
oral sucrose alone experienced
researchers38,39 suggest that limiting
choking, coughing, vomiting, or

Table 5

Infant pain assessment instruments used in

published research on oral sucrose analgesia

64 CriticalCareNurse Vol 32, No. 1, FEBRUARY 2012

sustained tachycardia or bradycardia.42 None of these adverse events

were considered clinically important,
and none of the babies who received
oral sucrose and NNS experienced
adverse events.42 McCullough et al25
described adverse events associated
with administration of oral sucrose
to preterm infants in stable condition who had insertion of a nasogastric tube. Brief apnea or self-limiting
bradycardia occurred in a few infants
as a result of the sucrose administered or insertion of the tube. None
of these events were clinically important or required intervention.
Necrotizing enterocolitis and hyperglycemia have been suspected adverse
effects, the latter more theoretical
than well documented.38 Oral sucrose
has not been proved to cause either
of these effects.38
The safety of oral sucrose for
very preterm infants has been a
focus of investigation, and the efficacy of the sugar in older infants
has been questioned. Scrutiny of
the literature on pain associated
with immunization and use of oral
sucrose at 2, 4, and 6 months of age
has led experts to conclude that the
analgesic effect of oral sucrose is
diminished at 4 months.30,38,39,43
The appropriate volume of oral
sucrose has also been examined,
and precise dosing based on age is
not clearly defined. Two independent measurements indicated that the
volume of a 24% solution of sucrose
administered from a pacifier dipped
once was no greater than 0.2 mL.38
Sucrose volumes ranging from 0.5
to 2 mL have been effective for analgesia for neonates.30,38,39,43,44 Interestingly, the analgesic effect is not
determined by the volume but
rather by the infants detection of a

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sweet taste.38 Investigators38,44 have

reported that 0.05 to 0.5 mL of a 24%
to 25% solution of sucrose or glucose
is sufficient to provide analgesia.
The onset of action of oral
sucrose is 10 seconds, peak action
occurs at 2 minutes, and the effect
persists approximately 5 to 10 minutes.37 Because of the rapid onset of
action, analgesia is not attributable
to oral absorption and clearance
from the circulation.
Research on use of oral sucrose
has evolved to include the investigation of more and varied populations
of patients and painful procedures.
For example, sucrose moderately
reduced pain in newborns of both
diabetic and nondiabetic mothers
when it was used for all medical
procedures performed in the first 2
days after birth.45 However, when
each procedure was analyzed separately, sucrose reduced pain for
venipuncture but not for intramuscular injection of vitamin K or heel
lance. Findings on the effectiveness
of oral sucrose in reducing pain
and/or distress associated with
screening for retinopathy of prematurity have been mixed.46,47
Studies other than those conducted in a NICU or a newborn nursery have had varied findings on the
use of oral sucrose for nonskinbreaking procedures. For example,
oral sucrose had no overall treatment
effect in infants who were younger
than 90 days and received the sugar
for bladder catheterization in the
emergency department.48 Another
example is use of oral sucrose for
insertion of nasogastric tubes.
McCullough et al25 reported that
insertion in neonates evokes a pain
response comparable to that associated with heel lance. In a randomized,

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Table 6

Variations in the evidence on analgesia with oral sucrose

Age (preterm, term, neonate, infant)

Weight (very low birth weight, low birth weight, healthy weight)
Acuity (healthy, undergoing mechanical ventilation with an endotracheal tube)
Intensity of pain stimulus (traditional lancet, automated lancet)
Oral sucrose as sole intervention
Oral sucrose as 1 of 2 or more interventions (breast milk, kangaroo care, facilitated
tucking by parents)
Clinical setting (newborn nursery, neonatal intensive care unit)
Pain assessment scale (N-PASS, PIPP, CRIES)
Pain assessment physiological parameters (oxygen saturation, heart rate, blood pressure)
Pain assessment timing (before, during, after procedure)
Pain assessment as sole metric or combined with distress measures
Sweet solution (glucose, sucrose, 10%, 24%, 50%)
Sweet solution preparation (commercial, prepared by pharmacy, natural, preserved)
Medical history (infant of healthy mother, infant of diabetic mother)
Ethics (placebo, standard of care)
Abbreviations: CRIES, cry, requirement for increased oxygen administration, increase in vital signs,
expression, and sleeplessness assessment; N-PASS, Neonatal Pain, Agitation, and Sedation Scale; PIPP,
Premature Infant Pain Profile.

double-blind, placebo-controlled
clinical trial,25 a 24% solution of oral
sucrose was effective in reducing
the behavioral and physiological
pain responses to insertion of a
nasogastric tube in preterm infants.
Adverse effects (ie, brief apnea, selflimiting bradycardia) were few and
occurred equally in each group of
patients, leading to the conclusion
that oral sucrose for this procedure
is a safe intervention.
Last, analgesia due to oral sucrose
administered for venipuncture may
persist through subsequent care such
as diaper changes.49 Table 6 lists variations in research on oral sucrose
analgesia that make interpreting and
implementing the findings difficult.

Administration of
Oral Sucrose
Summary proceedings from the
Neonatal Pain-Control Group21

include sucrose as a drug class and

therapeutic option for the prevention and management of neonatal
pain and stress. In contrast, the
American Academy of Pediatrics
and the Canadian Paediatric Society44 list oral sucrose as a nonpharmacological pain prevention
measure for minor procedures.
Many hospitals dispense oral sucrose
through a supply chain or materialsmanagement venue; others dispense
the product via the hospital pharmacy. Oral sucrose packaging does
not include a national drug code.
The logistics of an electronic medical record necessitate pharmacy
control of oral sucrose if a provider
order and documentation on administration as with a medication are
required. Supplying oral sucrose on
patient care units as part of the units
stock instead of within the pharmacy or an electronic medication

CriticalCareNurse Vol 32, No. 1, FEBRUARY 2012 65

dispensing system provides immediate accessibility to clinicians and the

retention of administration of oral
sucrose as an independent nursing
intervention guided by evidencebased pain policies and protocols.

Table 7

1. Scope (eg, inpatient, outpatient laboratory, satellite surgery center)

2. Approval bodies/disciplines (eg, pain council, pharmacy)
3. Who can administer (eg, nurse, phlebotomist)
4. Purpose and definitions
5. Procedure
a. When to administer relative to a painful procedure
b. Method of administration (eg, pacifier, oral syringe)
c. Information about pacifier dips and the volume of solution
d. Indications or inclusion criteria
e. Contraindications or exclusion criteria
f. How families can participate with the administration of oral sucrose to their infant
g. Documentation of pain assessment after administration of oral sucrose

Patient Safety and

Administration
At one hospital, addition of oral
sucrose to preprinted admission
orders increased use of the sugar
from 8% to 65% for obtaining blood
samples at the time of admission.38
Oral sucrose may also be included in
admission order sets and pain management screens or bands within
electronic documentation systems.
The data collection form of the
National Data Base for Nursing Quality Indicators50 for pain assessmentintervention-reassessment cycles
does not include oral sucrose as a
specific analgesic intervention.
However, the form does have the
choice for Other, and oral sucrose
can be included in this intervention
option. Nurses should have the
means to document oral sucrose as
an intervention for pain management
with reassessment of pain after the
intervention. Nurses can document
oral sucrose as a component of a
patients plan of care and pain education for an infants family. Moreover, nurses may support parents
participating in this intervention.51
A patient care policy on use of
oral sucrose should reflect consensus among the following disciplines:
nursing, neonatology, general surgery, cardiothoracic surgery, pain
medicine, critical care medicine, and
pharmacy. A policy must specify who
can administer oral sucrose to newborns when minor invasive procedures are performed (eg, radiological

Oral sucrose policy components

6. Evidence

technologists, phlebotomists). Institution-specific factors (eg, product

availability) and parental preferences are important considerations
in evidence-based practice. Table 7
is an outline of the components of a
policy on use of oral sucrose.
Dunbar and colleagues30 described
the administration of oral sucrose
in combination with a pacifier
because of the added analgesic effect
of NNS. The oral sucrose was
dropped precisely onto the tongue
with an oral syringe and then the
infant was given a pacifier, or the
sugar was administered by dipping
the pacifier in the sucrose solution.42
Figures 1 and 2 show oral sucrose
packaging and an administration
option for different products.

Figure 1 Packages of Sweet-Ease

natural.
Image courtesy of Philips Childrens Medical
Ventures, Monroeville, Pennsylvania.

Parental Participation in
Procedures for
Pain Management
In light of the number of invasive procedures a hospitalized newborn experiences, not surprisingly
parents of babies in NICUs identified medical procedures as the major
source of pain.52 Parents desire information about and involvement with
their infants pain and have described

66 CriticalCareNurse Vol 32, No. 1, FEBRUARY 2012

Figure 2 TootSweet twist-tip vial.

Image courtesy of Natus Medical Inc, San Carlos,
California.

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specific ways in which staff in the

NICU can help them and their babies
cope with pain.53 Parents who are
empowered to administer oral sucrose
to their newborn might be less
affected by the infants pain and less
worried about their relationship
with the infant as a result of painful
experiences. Nurses are in an ideal
position to assess parents preferences for being involved in managing infants pain and to facilitate
parental independence in providing
nonpharmacological pain interventions as part of patient-family
centered care.

Case Reports
The following case reports are
about 2 patients treated in units
other than an NICU or a newborn
nursery. The standard of care for
minor painful procedures relative to
analgesic medications for infants is
represented. Age determinants for
analgesic effectiveness are considered as well as the combination of
oral sucrose with other nonpharmacological pain interventions. Incomplete details on pain control before
the time covered in these case reports
challenge nurses to consider possible
implications for the effectiveness or
ineffectiveness of oral sucrose.
Case Report 1: Oral Sucrose
Effective

A newborn boy with coarctation

of the aorta was hospitalized in a
cardiac intensive care unit. He was
swaddled in a radiant warmer bed.

To learn more about neonatal critical care,

read Assessment of Family Needs in Neonatal Intensive Care Units by Cynthia A. Mundy
in the American Journal of Critical Care, 2010;
19:156-163. Available at www.ajcconline.org.

www.ccnonline.org

His parents were consulting with a

physician outside the unit. No analgesics had been ordered as part of
the babys treatment plan. The
infant required percutaneous intravenous cannulation before surgical
correction of the cardiac abnormality. A pacifier dipped in a 24% solution of oral sucrose was provided to
the infant by a nurse 2 minutes
before the intravenous cannulation.
The infant had mild extremity withdrawal in response to the first
tourniquet application; his CRIES
score was 1. The CRIES pain assessment scale is used to measure cry,
requirement for increased oxygen
administration, increase in vital signs,
expression, and sleeplessness.53,54
Scores can range from 0 (no pain) to
10 (the worst possible pain). When
a site was chosen for the intravenous
cannulation and the procedure was
started with a break in the skin, the
baby continued to suck on the oral
sucrose pacifier. The pacifier was
redipped and offered to the baby 3
times during the procedure and for
approximately 1 minute after the
catheter was secured. The baby slept
through most of the procedure. During brief wakefulness, his CRIES
score never increased to greater than
1. The baby was swaddled again,
and he was resting peacefully when
the parents returned to the bedside.
Case Report 2: Oral Sucrose
Ineffective

A 4-month-old girl was hospitalized in a pediatric intensive care unit

with severe bronchopulmonary
dysplasia that necessitated highfrequency oscillatory ventilation
and prone positioning. When the
babys condition improved, oxygen
was administered via nasal cannula.

She required percutaneous intravenous cannulation for maintenance

intravenous fluid before transfer to
an acute care unit the next morning. The nurse caring for the baby
played a television channel in the
infants room that shows continual
imagery scenes accompanied by
music (eg, waterfalls, green meadows). No analgesics were ordered
as part of the babys treatment
plan. She was soothed only briefly
with oral sucrose for the first tourniquet application to an extremity.
As the procedure went on, with 3
unsuccessful attempts at percutaneous intravenous cannulation, oral
sucrose had no effect on the infants
pain, as indicated by no reduction
in a CRIES score of 8. Whether or
not adequate pain management
was provided earlier during hospitalization for multiple urgent and
necessary invasive procedures,
potentially resulting in hyperalgesia, was not clear. The ineffectiveness of oral sucrose might have been
attributable to the infants age.

Conclusion
Oral sucrose has a valuable role
in reducing procedural pain for
infants. Generally, the sugar is safe
and effective for infants who experience minor invasive procedures.
Inconsistencies in studies of the
analgesic effects of oral sucrose during common minor invasive procedures may be responsible for the
varied findings. Furthermore, an
optimal dose has yet to be determined. Nurses need to remember
that oral sucrose reduces, but may
not eliminate, pain. Combining oral
sucrose with other nonpharmacological interventions may enhance
pain relief. Oral sucrose should not

CriticalCareNurse Vol 32, No. 1, FEBRUARY 2012 67

be used as a first-line intervention

for moderate, severe, or chronic
pain in infants.
Oral sucrose for analgesia in
newborns remains an area of research
and a relevant topic of interest.
Additional investigation is needed
on repeated administration of oral
sucrose, optimal dosing, and use in
babies who have extremely low
birth weight, are in unstable condition, or are being treated with
mechanical ventilation.55 CCN
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Acknowledgment
In loving memory of Beverly Sahlaney.

Financial Disclosures
None reported.

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