Denise Harrison1,2, Catherine Larocque3,2, Mariana Bueno4, Yehudis Stokes3,2, Lucy Turner5, Brian Hutton6, Bonnie Stevens7,8. 1. Children's Hospital of Eastern Ontario (CHEO) Research Institute, Ottawa, Ontario, Canada; dharrison@cheo.on.ca. 2. School of Nursing, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada. 3. Children's Hospital of Eastern Ontario (CHEO) Research Institute, Ottawa, Ontario, Canada. 4. Departamento Enfermagem Materno-Infantil e Psiquiátrica (ENP), University of São Paulo, São Paulo, Brazil. 5. Institute of Health Economics, Edmonton, Alberta, Canada. 6. Ottawa Hospital Research Institute (OHRI), Ottawa, Ontario, Canada. 7. The Hospital for Sick Children, Toronto, Ontario, Canada; and. 8. Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada.
Abstract
CONTEXT: Abundant evidence of sweet taste analgesia in neonates exists, yet placebo-controlled trials continue to be conducted. OBJECTIVE: To review all trials evaluating sweet solutions for analgesia in neonates and to conduct cumulative meta-analyses (CMAs) on behavioral pain outcomes. DATA SOURCES: (1) Data from 2 systematic reviews of sweet solutions for newborns; (2) searches ending 2015 of CINAHL, Medline, Embase, and psychINFO. DATA EXTRACTION AND ANALYSIS: Two authors screened studies for inclusion, conducted risk-of-bias ratings, and extracted behavioral outcome data for CMAs. CMA was performed using random effects meta-analysis. RESULTS: One hundred and sixty-eight studies were included; 148 (88%) included placebo/no-treatment arms. CMA for crying time included 29 trials (1175 infants). From the fifth trial in 2002, there was a statistically significant reduction in mean cry time for sweet solutions compared with placebo (-27 seconds, 95% confidence interval [CI] -51 to -4). By the final trial, CMA was -23 seconds in favor of sweet solutions (95% CI -29 to -18). CMA for pain scores included 50 trials (3341 infants). Results were in favor of sweet solutions from the second trial (0.5, 95% CI -1 to -0.1). Final results showed a standardized mean difference of -0.9 (95% CI -1.1 to -0.7). LIMITATIONS: We were unable to use or obtain data from many studies to include in the CMA. CONCLUSIONS: Evidence of sweet taste analgesia in neonates has existed since the first published trials, yet placebo/no-treatment, controlled trials have continued to be conducted. Future neonatal pain studies need to select more ethically responsible control groups.
CONTEXT: Abundant evidence of sweet taste analgesia in neonates exists, yet placebo-controlled trials continue to be conducted. OBJECTIVE: To review all trials evaluating sweet solutions for analgesia in neonates and to conduct cumulative meta-analyses (CMAs) on behavioral pain outcomes. DATA SOURCES: (1) Data from 2 systematic reviews of sweet solutions for newborns; (2) searches ending 2015 of CINAHL, Medline, Embase, and psychINFO. DATA EXTRACTION AND ANALYSIS: Two authors screened studies for inclusion, conducted risk-of-bias ratings, and extracted behavioral outcome data for CMAs. CMA was performed using random effects meta-analysis. RESULTS: One hundred and sixty-eight studies were included; 148 (88%) included placebo/no-treatment arms. CMA for crying time included 29 trials (1175 infants). From the fifth trial in 2002, there was a statistically significant reduction in mean cry time for sweet solutions compared with placebo (-27 seconds, 95% confidence interval [CI] -51 to -4). By the final trial, CMA was -23 seconds in favor of sweet solutions (95% CI -29 to -18). CMA for pain scores included 50 trials (3341 infants). Results were in favor of sweet solutions from the second trial (0.5, 95% CI -1 to -0.1). Final results showed a standardized mean difference of -0.9 (95% CI -1.1 to -0.7). LIMITATIONS: We were unable to use or obtain data from many studies to include in the CMA. CONCLUSIONS: Evidence of sweet taste analgesia in neonates has existed since the first published trials, yet placebo/no-treatment, controlled trials have continued to be conducted. Future neonatal pain studies need to select more ethically responsible control groups.
Authors: Débora Joyce Duarte Oliveira; Kleyton Santos Medeiros; Ayane Cristine Alves Sarmento; Francisca Jennifer Duarte Oliveira; Ana Paula Ferreira Costa; Nilba Lima Souza; Ana Katherine Gonçalves; Maria de Lourdes Costa Silva Journal: BMJ Open Date: 2021-12-09 Impact factor: 2.692
Authors: Cian Wade; John Scott Frazer; Evelyn Qian; Lien M Davidson; Suzanne Dash; Anna Te Water Naudé; Rema Ramakrishan; Jalemba Aluvaala; Kokila Lakhoo; Mike English Journal: Lancet Child Adolesc Health Date: 2020-07-28