This randomized, assessor-blinded controlled trial evaluated the efficacy of oral sucrose combined with a pacifier versus a pacifier alone in reducing procedural pain and stress in preterm infants undergoing lung ultrasound (LUS). Conducted from November 2020 to January 2023, the study enrolled 60 preterm infants, with 29 in the sucrose-plus-pacifier group and 27 in the pacifier-alone group. Pain was assessed using the Premature Infant Pain Profile (PIPP) at baseline, during, and after the procedure. The primary endpoint was the change in PIPP scores across these time points. Repeated-measures ANOVA revealed significant changes in PIPP scores across procedural phases (p<0.0001), but no significant differences between the groups (p=0.16) or in group-by-phase interaction (p=0.21). Secondary endpoints included physiological parameters such as heart rate, oxygen saturation, and apneic episodes, which showed no significant differences between groups. No adverse events related to the interventions were reported. The findings suggest that oral sucrose does not provide additional analgesic benefit beyond pacifier use alone, indicating that non-nutritive sucking may suffice for comfort during LUS, supporting its classification as a minimally distressing procedure for neonates.
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This study looked at preterm infants, who are babies born before 37 weeks of pregnancy, and how they experience pain during a lung ultrasound, a test that uses sound waves to check their lungs. Researchers wanted to see if giving these babies sugar water along with a pacifier could help lessen their pain and stress during the test. They divided the infants into two groups: one group received sugar water and a pacifier, while the other group only received a pacifier. The researchers measured pain and other health signs during the ultrasound. They found that there was no difference in pain levels between the two groups. This suggests that just using a pacifier might be enough to keep these babies comfortable during the ultrasound. For parents, this means that simple methods like pacifiers can be effective in soothing their babies during minor procedures. However, it's important to note that while this study shows pacifiers are helpful, more research might be needed to explore other ways to support preterm infants during medical tests.
What this means for you: Using a pacifier alone is enough to comfort preterm babies during lung ultrasounds.
View Original Abstract ↓
Although lung ultrasound (LUS) is considered non-invasive in nature, handling and probe pressure may provoke pain and transient physiological changes in preterm infants. The aim of this study was to determine whether oral sucrose combined with a pacifier reduces procedural pain and stress in preterm infants undergoing bedside LUS. A two-arm randomized controlled trial was conducted between November 2020 and January 2023. Preterm infants undergoing LUS were randomized to receive either oral sucrose-plus-pacifier or pacifier-alone, administered 2 min before the scan. Pain was evaluated using the premature infant pain profile (PIPP) at four time points: baseline (30 s before intervention), 30 s into scanning, midpoint of the scan, and 30 s post-procedure. Physiological parameters (heart rate, oxygen saturation, and apneic episodes) and duration of the procedure were recorded. Group differences in PIPP scores were analyzed using repeated-measures ANOVA. Out of 60 infants enrolled, 30 infants were randomized in each group with data available on 29 infants in the sucrose-plus-pacifier group and 27 in the pacifier-alone group. Baseline demographics and clinical characteristics were comparable between groups. No statistically significant differences were observed in PIPP scores and physiological parameters at any time point between groups. Repeated-measures ANOVA showed a significant change in PIPP scores across procedural phases (p < 0.0001), with no differences between groups (p = 0.16) or group-by-phase interaction, indicating similar PIPP score trajectories in both groups (p = 0.21). Conclusion: Among preterm infants, sucrose did not add benefit to pacifier-alone for reducing procedural pain and stress during lung ultrasound.Trial registration: NCT05717088. What is Known • Lung ultrasound (LUS) is a bedside, radiation-free imaging modality increasingly used in preterm infants, but probe pressure and handling may still provoke mild procedural discomfort and physiological changes. • Oral sucrose is an established non-pharmacologic analgesic for painful neonatal procedures; however, its benefit during minimally invasive procedures such as LUS remains uncertain. What is New • In this randomized controlled trial, oral sucrose did not provide additional analgesic benefit beyond pacifier use alone during bedside LUS in preterm infants. • These findings suggest that non-nutritive sucking alone may be sufficient for comfort during LUS, supporting its classification as a minimally distressing neonatal bedside procedure.