A recent literature review published in the "Cochrane Database of Systematic Reviews" shows that in common invasive procedures in hospitals, such as venous blood collection, giving newborns a small amount of sucrose solution orally before the operation may effectively reduce their pain response, and is low-cost, safe and easy to perform.
Venous blood collection is a routine procedure for drawing blood from a vein with a needle for testing. However, for newborns whose pain regulation mechanisms are immature, especially premature infants in the neonatal intensive care unit, repeated acupuncture may cause a more intense pain experience and is associated with poorer growth and potential adverse brain development outcomes. Therefore, how to effectively prevent and deal with this type of pain in clinical practice has attracted much attention.
Sucrose solution, as an easily available, low-priced sweet liquid, has been used for decades in neonatal clinical practice for pre-acupuncture analgesia, i.e., it is dripped into the mouth a few minutes before the procedure to provide comfort and analgesia. However, the evidence for specific procedures (such as venous blood collection) has been relatively limited, and clinical application is obviously inconsistent. This time, the Cochrane team systematically reviewed relevant research, trying to provide a more solid scientific basis for this practice and promote the formation of a more unified standardized process in the neonatal ward.
The review included 29 clinical trials involving more than 2,700 neonates, both preterm and term, who received intravenous blood collection. The analysis results showed that compared with the control group who received no treatment, only water or "standard care", giving a small amount of sucrose before acupuncture "may" reduce the pain response of newborns at the moment of acupuncture and immediately after the operation; if sucrose is used in combination with non-nutritional sucking methods such as pacifiers, the analgesic effect is further enhanced.
Mariana Bueno, the study's corresponding author at the University of Toronto, noted that hospitalized newborns often receive multiple acupunctures, but not every one is accompanied by pain relief or comfort measures, and older children and adults rarely receive similar procedures without any analgesia. "The evidence shows that just a small amount of sucrose given before a procedure can reduce pain quickly and effectively, and we hope this review will give clinicians more confidence in using this approach and a greater willingness to maintain consistency in practice," she said.
In terms of safety, the included studies reported no immediate adverse effects from the use of sucrose in the small dose range required for analgesia. However, the current evidence mainly focuses on the short-term effects, and there is still a lack of sufficient data on the potential long-term effects of repeated use of sucrose in long-term hospitalized neonates throughout their hospitalization. The research team calls for longer-term follow-up in the future to fully evaluate the safety margin.
Co-author Ligyana Candido, a researcher at the University of Ottawa, said that many parents may be surprised that just a few drops of sugar water can significantly improve the baby's comfort during blood draws. This intervention is simple, cheap and effective, and has high practical value, especially when skin-to-skin contact or breastfeeding comfort is not possible. She emphasized that this type of "sweet analgesia" is not a complex drug therapy, but it can work within a few minutes and is worthy of promotion in medical settings with limited resources.
Although sucrose is widely used in many neonatal units around the world, this review found significant differences in how it is used across institutions, including a lack of uniform standards for dosage and timing of administration. Bueno noted that this high degree of variability was one of the most striking findings in the review, showing that even with clinical guidance, there is still room for improvement at the practical level. The research team believes that the results of the systematic review can provide a basis for the development of clearer standard operating procedures for neonatology departments in various countries, making the application of sucrose analgesia more standardized and consistent.
The author also emphasized that the use of sucrose should be strictly limited to reducing pain during invasive medical procedures, and should be recorded in medical records and medication orders like other drugs, and should not be used as a daily "panacea" to soothe crying babies. Co-author Jiale Hu from Virginia Commonwealth University also said that to ensure safety and consistency with clinical practice, sucrose should be included in a formal drug management system with clear definitions of indications, administration timing and dosage.
In terms of future research directions, the team suggests that follow-up trials should more compare the differences between different effective soothing measures, such as the relative effects of skin-to-skin contact, breastfeeding and sucrose analgesia, rather than continuing to compare with an untreated control group; at the same time, they should focus on evaluating the potential long-term effects of repeated sucrose analgesia in long-term hospitalized neonates, filling in the missing link in the current evidence chain, and providing scientific support for clinical development of more comprehensive pain management strategies.