[The efficacy of sucrose for the relief of pain in neonates: a systematic review of the literature].

OBJECTIVE To present a review of empirical studies published from 1993 to 2004 on the efficacy of sucrose solution for relieving pain in neonates. SOURCES OF DATA Information was obtained from the MEDLINE/PsycINFO/ISI WEB of SCIENCE/LILACS and SciELO databases by searching for "sucrose", "pain", "newborn" and "neonate". SUMMARY OF DATA Sucrose solution has demonstrated efficacy in pain relief during puncture procedures on samples of preterm and fullterm neonates. The recommendation is to administer oral sucrose, to the front of the tongue, 2 minutes before the painful procedure. Other non-pharmacological interventions, such as human breastmilk via nasogastric tube, non-nutritional suckling and being held at the breast, also demonstrated synergic analgesic effects when administered in association with sucrose. The majority of studies demonstrated a positive pain relief effect with a single 2 ml dose at 25%. Conclusions could not be drawn on the best repeat administration scheme; in the few studies that did provide an indication, the dose was 0.1 ml at 24%. The analgesic pain relief effect promoted by the sucrose was observed through altered behavioral responses, facial activity and crying. Heart rate underwent larger reductions as a result of sucrose administration during painful procedures than any of the other physiological responses. CONCLUSIONS The efficacy of a single dose of sucrose for the relief of acute pain neonates is well documented in the literature. However, there are not yet definite conclusions on the scheme of use for repeated doses of sucrose.