Abstract：Objective To investigate the efficacy of oral sweet solutions in relieving pain caused by vaccination in infants aged 1 to 12 months. Methods Related databases were searched to find related randomized control trails (RCTs). The quality of these RCTs was evaluated. The Meta analysis was performed using RevMan 5.3. Results A total of 20 RCTs involving 2 376 infants were included, and quality assessment showed that 6 RCTs had grade A quality and 14 had grade B quality. The Meta analysis showed that compared with sterile water, 25%-75% oral sweet solution significantly reduced crying time (WMD = -21.16, 95%CI -39.66 to -2.77, P < 0.05) and the proportion of crying time (the duration of crying /3-minute periods after the injection) (WMD = -13.83, 95%CI -20.88 to -6.78, P < 0.01), while the crying time showed no significant difference between the group treated with oral administration of 12% sucrose solution and non-intervention group. Conclusions Oral sweet solution (25%-75%; 2 mL) given 2 minutes before vaccination can effectively relieve the pain caused by vaccination in infants aged 1-12 months.
CHEN Shao-Lin,Harrison Denise,HUANG Rui-Rui et al. Efficacy of sweet solutions in relieving pain caused by vaccination in infants aged 1 to 12 months: a systematic review[J]. CJCP, 2016, 18(6): 534-540.
WHO. Vaccine-preventable diseases and vaccines.[2016-3-24]
[2]
MacLaren J, Cohen L. Interventions for paediatric procedure-related pain in primary care[J]. Paediatr Child Health, 2007, 12(2): 111-116.
[3]
Harrison D, Stevens B, Bueno M, et al. Efficacy of sweet solutions for analgesia in infants between 1 and 12 months of age: a systematic review[J]. Arch Dis Child, 2010, 95(6): 406-413.
[4]
Bueno M, Yamada J, Harrison D, et al. A systematic review and Meta-analyses of nonsucrose sweet solutions for pain relief in neonates[J]. Pain Res Manag, 2013, 18(3): 153-161.
[5]
Curry DM, Brown C, Wrona S. Effectiveness of oral sucrose for pain management in infants during immunizations[J]. Pain Manag Nurs, 2012, 13(3): 139-149.
[6]
Goswami G, Upadhyay A, Gupta NK, et al. Comparison of analgesic effect of direct breastfeeding, oral 25% dextrose solution and placebo during 1st DPT vaccination in healthy term infants: a randomized, placebo controlled trial[J]. Indian Pediatr, 2013, 50(7): 649-653.
[7]
Harrington JW, Logan S, Harwell C, et al. Effective analgesia using physical interventions for infant immunizations[J]. Pediatrics, 2012, 129(5): 815-822.
[8]
Harrison D, Yamada J, Adams-Webber T, et al. Sweet tasting solutions for reduction of needle-related procedural pain in children aged one to 16 years[J]. Cochrane Database of Syst Rev, 2015, (5): CD008408.
[9]
Higgins JPT, Green S. Cochrane handbook for systematic reviews of interventions version 5.1.0 [M/OL]. [2012-05-10]. Newyork: John Wiley & Sons, The Cochrane Collaboration, 2011.
[10]
Allen KD, White DD, Walburn JN, et al. Sucrose as an analgesic agent for infants during immunization injections[J]. Arch Pediatr Adolesc Med, 1996, 150(3): 270-274.
[11]
Barr RG, Young SN, Wright JH, et al. Sucrose analgesia" and diphtheria-tetanus-pertussis immunizations at 2 and 4 months[J]. J Dev Behav Pediatr, 1995, 16(4): 220-225.
[12]
Dilli D, Küçük IG, Dallar Y, et al. Interventions to reduce pain during vaccination in infancy[J]. J Pediatr 2009, 154(3): 385-390.
[13]
Hatfield LA. Gusic ME, Dyer AM, et al. Analgesic properties of oral sucrose during routine immunizations at 2 and 4 months of age[J]. Pediatrics, 2008, 121(2): e327- e334.
[14]
Hatfield LA. Sucrose decreases infant biobehavioral pain response to immunizations: a randomized controlled trial[J]. J Nurs Scholarsh, 2008, 40(3): 219-225.
[15]
Kassab M, Sheehy A, King M, et al. A double-blind randomised controlled trial of 25% oral glucose for pain relief in 2-month old infants undergoing immunisation[J]. Int J Nurs Stud, 2012, 49(3): 249-256.
[16]
Lewindon PJ, Harkness L, Lewindon N, et al. Randomised controlled trial of sucrose by mouth for the relief of infant crying after immunisation[J]. Arch Dis Child, 1998, 78(5): 453-456.
[17]
Lindh V, Wiklund U, Blomquist HK, et al. EMLA cream and oral glucose for immunization pain in 3-month-old infants[J]. Pain, 2003, 104(1-2): 381-388.
[18]
Morelius E, Theodorsson E, Nelson N, et al. Stress at three-month immunization: parents' and infants' salivary cortisol response in relation to the use of pacifier and oral glucose[J]. Eur J Pain, 2009, 13(2): 202-208.
[19]
Ramenghi LA, Webb AV, Shevlin PM, et al. Intra-oral administration of sweet-tasting substances and infants' crying response to immunization: a randomized, placebo-controlled trial[J]. Biol Neonate, 2002, 81(3): 163-169.
[20]
Reis EC, Roth EK, Syphan JL, et al. Effective pain reduction for multiple immunization injections in young infants[J]. Arch Pediatr Adolesc Med, 2003, 157(11): 1115-1120.
[21]
Thyr M, Sundholm A, Teeland L, et al. Oral glucose as an analgesic to reduce infant distress following immunization at the age of 3, 5 and 12 months[J]. Acta Paediatr, 2007, 96(2): 233-236.
[22]
Mowery B. Effects of sucrose on immunization injection pain in Hispanic infants[D]. Unpublished thesis. Virginia: University of Virginia; 2007.
[23]
Poulsen M. Cane sugar unsuitable for use as analgesic in paediatric vaccination[J]. Sygeplejersken/Danish Journal of Nursing, 2009, 106(6): 54-57.
[24]
Soriano Faura J, Gomez Gil A. Controlled clinical study of sucrose administration to reduce the duration of crying in infants undergoing vaccination[J]. Acta Pediátrica Española, 2003, 61(5): 234-238.
[25]
Priambodo A, Julia M, Ismail D. Effect of oral sugar solution for reducing pain in infants underwent diphtheria, pertussis, tetanus (DPT) immunization: a randomized, double-blind controlled trial[J]. Paediatrica Indonesiana, 2008, 48(1): 23-27.
[26]
Amna Nagaty AE, Basma Abd EA, Hekmat E. AK, et al. Effect of oral sucrose administration on reducing infantile sensation of pain during obligatory immunizations at minia city[J]. AAMJ, 2014, 12(4): 70-92.
[27]
Stevens B, Yamada J, Lee GY et al. Sucrose for analgesia in newborn infants undergoing painful procedures[J]. Cochrane Database Syst Rev, 2013, 1: CD001069.
[28]
Kassab M, Foster JP, Foureur M, et al.Sweet-tasting solutions for needle-related procedural pain in infants one month to one year of age[J]. Cochrane Database Syst Rev, 2012, 12: CD008411.
[29]
McCall JM, DeCristofaro C, Elliott L. Oral sucrose for pain control in nonneonate infants during minor painful procedures[J]. J Am Assoc Nurse Pract, 2013, 25(5): 244-252.
