Eur J Pediatr DOI 10.1007/s00431-014-2472-6

ORIGINAL ARTICLE

Oral glucose in preterm neonates during oropharyngeal suctioning: a randomized controlled cross-over trial Katharina Vezyroglou & Katrin Mehler & Angela Kribs & Ingrid Becker & Kristina Langhammer & Bernhard Roth & Christoph Hünseler

Received: 8 September 2014 / Revised: 29 November 2014 / Accepted: 4 December 2014 # Springer-Verlag Berlin Heidelberg 2014

Abstract To investigate whether orally applied glucose reduces pain response during oropharyngeal suctioning in preterm infants with a birth weight >1500 g, we conducted a randomized, double-blind, placebo-controlled cross-over trial on 32 preterm infants undergoing oropharyngeal suctioning while on nasal continuous positive airway pressure (CPAP). The Premature Infant Pain Profile (PIPP) score was assessed and compared in a cross-over design to investigate whether there was a significant difference in the patients’ pain response. The mean PIPP score during oropharyngeal suctioning after placebo was 8.6 (KI 7.8–9.4). After glucose administration, the mean PIPP score was 8.0 (KI 7.1–8.9). Comparison of the treatment effects reached no statistic significance (p=0.23). During the oral study drug administration

Communicated by Patrick Van Reempts K. Vezyroglou (*) : K. Mehler : A. Kribs : K. Langhammer : B. Roth : C. Hünseler Department of Neonatology and Pediatric Intensive Care Medicine, Children’s Hospital, University of Cologne, Kerpener Str. 62, 50937 Cologne, Germany e-mail: [email protected] K. Mehler e-mail: [email protected] A. Kribs e-mail: [email protected] K. Langhammer e-mail: [email protected] B. Roth e-mail: [email protected] C. Hünseler e-mail: [email protected] I. Becker Institute of Medical Statistics, Informatics and Epidemiology, University of Cologne, Cologne, Germany e-mail: [email protected]

during nasal CPAP, we observed 47 adverse events, but none necessitated therapeutic intervention and none was classified as serious. Conclusion: In our study, late preterm infants in the first days of life did not benefit significantly from analgesia with glucose during oropharyngeal suctioning. The oral administration of glucose under nasal CPAP led to no serious adverse events. Keywords Pain . Preterm neonates . Glucose . Analgesia . Suctioning . CPAP Abbreviations AE Adverse event CPAP Continuous positive airway pressure PIPP Premature Infant Pain Profile SAE Serious adverse event

Introduction Background Pain in term and preterm neonates has been an important topic in clinical research for years. This is due to growing evidence that repeated pain in the neonatal period has not only obvious short-term but also long-term deleterious effects. Thus, it has been shown to alter pain sensitivity [20] and increase somatization [17]. Furthermore attention deficit disorders, learning disorders, and behavioral problems have been associated with repetitive pain in preterm infants [25]. So it is of outmost importance to implement the available knowledge in clinical care developing adequate therapies and preventive strategies for effective management of neonatal pain [2].

Eur J Pediatr

GlucosePlacebo (GP) was treated with glucose 20 % (active treatment) in period 1 and with water (placebo) in period 2; group PlaceboGlucose (PG) received the treatments in the reverse order.

One of the potentially painful procedures most frequently carried out in this patient population is oropharyngeal suctioning [10, 29]. For needle-related procedures, the painmodulating effects of oral sugars, including glucose, in term and preterm neonates have been sufficiently demonstrated [33, 19, 8, 26]. However, only little research has been done on the effects of these procedures in oropharyngeal suctioning of neonates receiving nasal continuous positive airway pressure (CPAP); we are aware of only one single study [4]. Since oropharyngeal suctioning differs from needle-related procedures by not damaging tissue, separate placebo-controlled studies are needed to broaden the recommendation of sweet solution analgesia to this procedure.

Patient population and study setting The patient population comprised 40 patients recruited between January 2009 and July 2010. The inclusion criteria were preterm birth (gestational age 2000 g, 6 Ch

Oral glucose in preterm neonates during oropharyngeal suctioning: a randomized controlled cross-over trial.

To investigate whether orally applied glucose reduces pain response during oropharyngeal suctioning in preterm infants with a birth weight >1500 g, we...
376KB Sizes 1 Downloads 7 Views