BACKGROUND: Sucrose has been demonstrated to provide analgesia for minor painful procedures in infants. However, results of trials investigating other sweet solutions for neonatal pain relief have not yet been synthesized.OBJECTIVE: To establish the efficacy of nonsucrose sweet-tasting solutions for pain relief during painful procedures in neonates.METHOD: The present article is a systematic review and meta-analyses of the literature. Standard methods of the Cochrane Neonatal Collaborative Review Group were used. Literature searches were reviewed for randomized controlled trials investigating the use of sweet solutions, except sucrose, for procedural pain management in neonates. Outcomes assessed included validated pain measures and behavioural and physiological indicators.RESULTS: Thirty-eight studies (3785 neonates) were included, 35 of which investigated glucose. Heel lancing was performed in 21/38 studies and venipuncture in 11/38 studies. A 3.6-point reduction in Premature Infant Pain Profile scores during heel lances was observed in studies comparing 20% to 30% glucose with no intervention (two studies, 124 neonates; mean difference −3.6 [95% CI −4.6 to −2.6]; P<0.001; I²=54%). A significant reduction in the incidence of cry after venipuncture for infants receiving 25% to 30% glucose versus water or no intervention was observed (three studies, 130 infants; risk difference −0.18 [95% CI −0.31 to −0.05]; P=0.008, number needed to treat = 6 [95% CI 3 to 20]; I²=63%).CONCLUSIONS: The present systematic review and meta-analyses demonstrate that glucose reduces pain scores and crying during single heel lances and venipunctures. Results indicate that 20% to 30% glucose solutions have analgesic effects and can be recommended as an alternative to sucrose for procedural pain reduction in healthy term and preterm neonates.

中文翻译：

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非蔗糖甜味剂缓解新生儿疼痛的系统评价和荟萃分析

背景：蔗糖已被证明可为婴儿的轻微痛苦手术提供镇痛作用。然而，尚无关于研究其他甜味解决方案缓解新生儿疼痛的试验结果。目的：建立非蔗糖甜味解决方案在新生儿痛苦手术中缓解疼痛的功效。文献的荟萃分析。使用Cochrane新生儿协作评估小组的标准方法。文献检索对随机对照试验进行了回顾，该试验研究了除蔗糖外使用甜味剂治疗新生儿程序性疼痛的方法。评估的结果包括经过验证的止痛措施以及行为和生理指标。结果：进行了38项研究（3785例新生儿），其中35个研究了葡萄糖。在21/38研究中进行了脚跟采血，在11/38研究中进行了静脉穿刺。在不进行干预的情况下比较20％至30％的葡萄糖而未进行干预的研究中，观察到脚跟长矛期间的婴儿早期疼痛特征评分降低了3.6点（两项研究，124例新生儿；平均差异为-3.6 [95％CI -4.6至-2.6]； P <0.001；我² = 54％）。与水或无干预措施相比，接受25％至30％葡萄糖的婴儿在静脉穿刺后哭泣的发生率显着降低（三项研究，130名婴儿；风险差异为-0.18 [95％CI -0.31至-0.05]； P = 0.008，需要治疗的人数= 6 [95％CI 3至20]； I ² = 63％）。结论：本系统的回顾和荟萃分析表明，葡萄糖可降低单脚长矛和静脉穿刺过程中的疼痛评分和哭泣。结果表明，20％至30％的葡萄糖溶液具有镇痛作用，可以推荐作为蔗糖的替代品，以减轻健康足月和早产儿的手术疼痛。