Cochrane · systematic review · CD001069

Sucrose for analgesia in newborn infants undergoing painful procedures

Stevens, B, Yamada, J, Ohlsson, A, et al. · Cochrane Database of Systematic Reviews · 2016 · Cochrane Library

NeonatalAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
41
current version
GRADE rated
41
No studies
0
Included studies
NR
No studies 0 · 0%Ungraded 0 · 0%Very low 0 · 0%Low 16 · 39%Moderate 16 · 39%High 9 · 22%

Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.

Questions and results

Comparison

Population: neonates with heel lance‐associated pain
5 questions
OutcomeEffectEvidenceStatus / GRADE
PIPP at 30 s after heel lance Range of scale 0‐21 for infants < 28 weeks PMA and 0‐18 for infants > 36 weeks PMA. A lower score = less pain (Stevens 1996)
no estimate extracted2 studies · 105 participantsLow
PIPP at 60 s after heel lance Range of scale 0‐21 for infants < 28 weeks PMA and 0‐18 for infants >3 6 weeks PMA A lower score = less pain (Stevens 1996; Stevens 2014a)
no estimate extracted1 study · 31 participantsLow
PIPP score during heel lance (1st heel lance) Range of scale 0‐21 for infants < 28 weeks PMA and 0‐18 for infants > 36 weeks PMA A lower score = less pain (Stevens 1996; Stevens 2014a)
no estimate extracted1 study · 107 participantsModerate
DAN score at 30 s after heel lance Range of scale 0‐10 A lower score = less pain (Carbajal 1997)
no estimate extracted1 study · 32 participantsLow
NIPS during heel lance Range of scale 0‐7 A lower score = less pain Lawrence 1993
no estimate extracted1 study · 56 participantsModerate

Comparison

Population: neonates with heel lance‐associated pain
1 question
OutcomeEffectEvidenceStatus / GRADE
PIPP ‐ Preterm infants
no estimate extracted1 study · 47 participantsLow

Comparison

Population: newborns with heel lance‐associated pain
3 questions
OutcomeEffectEvidenceStatus / GRADE
NFCS Range of scale 0‐10 in term infants 0‐9 in preterm infants A lower score = less pain Grunau 1987
no estimate extracted1 study · 100 participantsLow
PIPP 30 s after heel lance (term and preterm infants) Range of scale 0‐21 for infants < 28 weeks PMA and 0‐18 for infants > 36 weeks PMA A lower score = less pain (Stevens 1996; Stevens 2014a)
no estimate extracted3 studies · 278 participantsHigh
PIPP 60 s after heel lance Range of scale 0‐21 for infants < 28 weeks PMA and 0‐18 for infants > 36 weeks PMA A lower score = less pain (Stevens 1996; Stevens 2014a)
no estimate extracted2 studies · 164 participantsHigh

Comparison

Population: neonates with heel lance‐associated pain
1 question
OutcomeEffectEvidenceStatus / GRADE
PIPP score Range of scale 0‐21 for infants < 28 weeks PMA and 0‐18 for infants > 36 weeks PMA A lower score = less pain (Stevens 1996; Stevens 2014a)
no estimate extracted1 study · 47 participantsLow

Comparison

Population: neonates with heel lance‐associated pain
1 question
OutcomeEffectEvidenceStatus / GRADE
PIPP score Range of scale 0‐21 for infants < 28 weeks PMA and 0‐18 for infants > 36 weeks PMA A lower score = less pain (Stevens 1996; Stevens 2014a)
no estimate extracted1 study · 47 participantsLow

Comparison

Population: neonates with pain associated with heel lance
1 question
OutcomeEffectEvidenceStatus / GRADE
NIPS score Range of scale 0‐7 A lower score = less pain Lawrence 1993
no estimate extracted1 study · 42 participantsLow

Comparison

Population: neonates with pain associated with heel lance
1 question
OutcomeEffectEvidenceStatus / GRADE
Revised NFCS Range of scale 0‐10 in term infants 0‐9 in preterm infants A lower score = less pain Grunau 1987
no estimate extracted1 study · 343 participantsModerate

Comparison

Population: neonates with pain associated with heel lance
1 question
OutcomeEffectEvidenceStatus / GRADE
Revised NFCS Range of scale 0‐10 in term infants 0‐9 in preterm infants A lower score = less pain Grunau 1987
no estimate extracted1 study · 343 participantsModerate

Comparison

Population: neonates with pain associated with heel lance
1 question
OutcomeEffectEvidenceStatus / GRADE
Revised NFCS Range of scale 0‐10 in term infants 0‐9 in preterm infants A lower score = less pain Grunau 1987
no estimate extracted1 study · 337 participantsModerate

Comparison

Population: neonates with pain associated with repeated heel lances
2 questions
OutcomeEffectEvidenceStatus / GRADE
Total Bernese Pain Scale for Neonates (BPSN) during heel lance
no estimate extracted1 study · 48 participantsModerate
Total Bernese Pain Scale for Neonates during recovery from heel lance
no estimate extracted1 study · 48 participantsModerate

Comparison

Population: neonates with pain associated with repeated heel lances
2 questions
OutcomeEffectEvidenceStatus / GRADE
Total Bernese Pain Scale for Neonates during heel lance (preterm infants)
no estimate extracted1 study · 47 participantsModerate
Total Bernese Pain Scale for Neonates during recovery (preterm infants)
no estimate extracted1 study · 47 participantsModerate

Comparison

Population: neonates with pain associated with venipuncture
1 question
OutcomeEffectEvidenceStatus / GRADE
NIPS score in term and preterm infants Range of scale 0‐7 A lower score = less pain Lawrence 1993
no estimate extracted1 study · 111 participantsModerate

Comparison

Population: neonates with pain associated with venipuncture
1 question
OutcomeEffectEvidenceStatus / GRADE
PIPP score during venipuncture Range of scale 0‐21 for infants < 28 weeks PMA and 0‐18 for infants > 36 weeks PMA A lower score = less pain (Stevens 1996; Stevens 2014a)
no estimate extracted1 study · 213 participantsHigh

Comparison

Population: neonates with pain associated with venipuncture
4 questions
OutcomeEffectEvidenceStatus / GRADE
PIPP score Range of scale 0‐21 for infants < 28 weeks PMA and 0‐18 for infants > 36 weeks PMA A lower score = less pain (Stevens 1996; Stevens 2014a)
no estimate extracted1 study · 76 participantsModerate
PIPP score during post‐injection period Range of scale 0‐21 for infants < 28 weeks PMA and 0‐18 for infants > 36 weeks PMA A lower score = less pain (Stevens 1996; Stevens 2014a)
no estimate extracted1 study · 76 participantsModerate
DAN score during venipuncture (preterm infants) Range of scale 0‐10 A lower score = less pain (Carbajal 1997)
no estimate extracted1 study · 76 participantsModerate
DAN score during the post‐injection period Range of scale 0‐10 A lower score = less pain (Carbajal 1997)
no estimate extracted1 study · 76 participantsModerate

Comparison

Population: neonates with pain associated with intramuscular injection
2 questions
OutcomeEffectEvidenceStatus / GRADE
NIPS during 1‐2 minutes after IM injection Range of scale 0‐7 A lower score = less pain Lawrence 1993
no estimate extracted1 study · 60 participantsLow
PIPP during IM injection (term infants) ‐ Infants of non‐diabetic and diabetic mothers Range of scale 0‐21 for infants < 28 weeks PMA and 0‐18 for infants > 36 weeks PMA A lower score = less pain (Stevens 1996; Stevens 2014a)
no estimate extracted1 study · 232 participantsHigh

Comparison

Population: neonates with pain associated with intramuscular injection
1 question
OutcomeEffectEvidenceStatus / GRADE
NIPS during 1‐2 minutes after immunization Range of scale 0‐7 A lower score = less pain Lawrence 1993
no estimate extracted1 study · 60 participantsLow

Comparison

Population: neonates with pain associated with bladder catheterization
1 question
OutcomeEffectEvidenceStatus / GRADE
Change in DAN score Range of scale 0‐10 A lower score = less pain (Carbajal 1997)
no estimate extracted1 study · 33 participantsModerate

Comparison

Population: neonates with pain associated with orogastric tube insertion
3 questions
OutcomeEffectEvidenceStatus / GRADE
PIPP score intra procedure Range of scale 0‐21 for infants < 28 weeks PMA and 0‐18 for infants > 36 weeks PMA A lower score = less pain (Stevens 1996; Stevens 2014a)
no estimate extracted1 study · 105 participantsHigh
PIPP score 30 seconds post procedure Range of scale 0‐21 for infants < 28 weeks PMA and 0‐18 for infants > 36 weeks PMA A lower score = less pain (Stevens 1996; Stevens 2014a)
no estimate extracted1 study · 105 participantsHigh
PIPP score 1 min post procedure Range of scale 0‐21 for infants < 28 weeks PMA and 0‐18 for infants > 36 weeks PMA A lower score = less pain (Stevens 1996; Stevens 2014a)
no estimate extracted1 study · 105 participantsHigh

Comparison

Population: neonates with pain/distress associated with ROP examination
1 question
OutcomeEffectEvidenceStatus / GRADE
PIPP during exam Range of scale 0‐21 for infants < 28 weeks PMA and 0‐18 for infants > 36 weeks PMA A lower score = less pain (Stevens 1996; Stevens 2014a)
no estimate extracted1 study · 32 participantsLow

Comparison

Population: neonates
1 question
OutcomeEffectEvidenceStatus / GRADE
PIPP score during eye examination Range of scale 0‐21 for infants < 28 weeks PMA and 0‐18 for infants > 36 weeks PMA A lower score = less pain (Stevens 1996; Stevens 2014a)
no estimate extracted3 studies · 134 participantsModerate

Comparison

Population: neonates undergoing circumcision
2 questions
OutcomeEffectEvidenceStatus / GRADE
N‐PASS score during circumcision Range of scale 0‐13 A lower score = less pain (Hummel 2010)
no estimate extracted1 study · 60 participantsLow
N‐PASS score after 5 min Range of scale 0‐13 A lower score = less pain (Hummel 2010)
no estimate extracted1 study · 60 participantsLow

Comparison

Population: neonates undergoing circumcision
2 questions
OutcomeEffectEvidenceStatus / GRADE
N‐PASS score during circumcision Range 0‐13 A lower score = less pain (Hummel 2010)
no estimate extracted1 study · 60 participantsLow
N‐PASS score after 5 min Range 0‐13 A lower score = less pain (Hummel 2010)
no estimate extracted1 study · 60 participantsLow

Comparison

Population: neonates undergoing echocardiography
1 question
OutcomeEffectEvidenceStatus / GRADE
PIPP
no estimate extracted1 study · 104 participantsLow

Comparison

Population: neonates with pain associated with potentially painful procedures for 7 days
2 questions
OutcomeEffectEvidenceStatus / GRADE
Motor development and vigor (MDV) domain of the NAPI tool Normative mean and SD at 36 weeks PMA 63 (14.5) Higher scores are associated with more mature behaviour (Snider 2005)
no estimate extracted1 study · 93 participantsHigh
Alertness and orientation (AO) domain of the NAPI tool Normative mean and SD at 36 weeks PMA 54 (19.4) Higher scores are associated with more mature behaviour (Snider 2005)
no estimate extracted1 study · 93 participantsHigh