Background: The efficacy of sucrose for relieving procedural pain in neonates has been investigated in many studies. To date, no systematic review has been performed. Objectives: To determine (1) the efficacy of sucrose in reducing procedural pain and (2) the most effective dose. Methods: The literature was searched using MEDLINE and EMBASE. Data from all double-blind randomized controlled trials (RCTs) were examined to quantify estimates of efficacy for various sucrose doses and water (placebo). Data were extracted for term and preterm neonates who received heelstick or venipuncture. The primary outcome was the proportion of time crying (mean or median) during the first three minutes after the painful stimulus. Data were combined across studies using a random effects model (Cochrane, 1954), adapted for use with single groups, producing a point estimate and 95% confidence interval (CI) for statistical comparison of results. Results: Thirteen RCTs were identified; eight were rejected as data were inappropriate, not extractable, or the primary outcome was not measured. Five studies provided data on 271 infants. The proportion of time crying and 95% CIs for water and each dose of sucrose were: Table The proportion of time crying did not differ between the 0.18g and water groups(p>0.05). Proportion of time crying for all other sucrose doses was significantly lower than 0.18g and water. Doses of 0.24g or larger did not differ significantly (p>0.05). There were no differences in proportion of time crying between term and preterm neonates. Conclusions: Sucrose reduced the proportion of time crying during painful procedures in neonates. The 0.18g dose of sucrose was ineffective. Doses of 0.24g are as effective as larger doses. There appears to be no addional benefit above 0.5g.
