Sucrose or glucose compared to breast milk for pain control in preterm infants: a systematic review and meta-analysis

The aim of this systematic review/meta-analysis of randomized clinical trials (RCTs) was to determine the efficacy of sucrose or glucose (SG) in preterm infants requiring heel lancing and venipuncture compared to breast milk or expressed breast milk (BM/EBM) for pain control and crying duration. Six RCTs (525 infants) comparing sucrose (24%) or glucose (30%, 10%, 25%) with BM/EBM were included. There was no difference between the alternatives in pain reduction at 30 s post-procedure measured with the Premature Infant Pain Profile (PIPP/PIPP-R) scores (MD -0.95, 95% CI −2.43; 0.54, Low certainty evidence). SG reduced the crying duration (MD –6.88, 95%CI −11.42; −2.34, Moderate certainty evidence). There were no differences between SG and BM/EBM in heart rate change or adverse events. In conclusion, moderate certainty evidence suggests that SG may be superior to BM/EBM for reducing crying duration during heel lancing and venipuncture procedures, but not for reducing pain intensity measured with PIPP/PIPP-R.ObjectiveTo determine the efficacy of sucrose or glucose (SG) in preterm infants requiring heel lancing and venipuncture compared to breast milk or expressed breast milk (BM/EBM) for pain control and crying duration.Study designSystematic review and meta-analysis of randomized clinical trials.ResultsSix RCTs (525 infants) comparing sucrose (24%) or glucose (30%, 10%, 25%) with BM/EBM. There was no difference between the alternatives in pain reduction at 30 s post-procedure measured with the Premature Infant Pain Profile (PIPP/PIPP-R) scores (MD −0.95, 95% CI −2.43; 0.54, Low certainty evidence). SG reduced the crying duration (MD –6.88, 95%CI −11.42; −2.34, Moderate certainty evidence). There were no differences between SG and BM/EBM in heart rate change or adverse events.ConclusionsModerate certainty evidence suggests that SG may be superior to BM/EBM for reducing crying duration during heel lancing and venipuncture procedures, but not for reducing pain intensity measured with PIPP/PIPP-R.