In their article, “Efficacy and safety of sucrose for procedural pain relief in preterm and term neonates,” Gibbins, Stevens, Hodnett, Pinelli, Ohlsson, and Darlington (2002) present the findings of their quantitative study, the purpose of which was to expand information and awareness about the use of sucrose for pain relief in preterm and term neonates. The researchers argued that while previous research had investigated the efficacy of sucrose for procedural pain relief in the same age cohort, existing studies lacked methodological rigor and failed to produce clear, evidence-based procedures that clinicians could adopt as best practices. For this reason, Gibbins et al. implemented a randomized controlled experimental trial in order to determine which intervention among sucrose and nonnutritive sucking, sucrose alone, or sterile water and nonnutritive sucking was deemed most effective and safe with respect to reducing pain in a standard heel lance procedure. Pain was measured using a standard pain profile instrument. Based on the data collected, the researchers concluded that the most effective and safe intervention is the combination of sucrose and nonnutritive sucking. In their conclusions, the authors provide guidelines for clinical practice and for future research.

The study conducted by Gibbins et al., while not relevant to all areas of nursing practice, is certainly relevant for nurses working in neonatal units; the authors indicated that 7-10% of infants are born before term and are admitted to NICUs, where they undergo routine medical procedures intended to improve their chances of survival and health. These procedures, however, are not without deleterious side effects, including pain and long-term tissue damage, and for this reason, the researchers were able to defend the rationale for the study. Any research that can produce evidence-based recommendations for clinicians with respect to reducing pain experienced by the neonate offers advances in medical service.

The variables examined in the study included pain, which the authors operationalized by citing the definition of pain as articulated by the International Association for the Study of Pain, efficacy, and safety, and the relationship of the preceding variables to the administration or absence of sucrose and nonnutritive sucking. To examine the relationship among the variables, the researchers constituted a sample of 190 neonates out of an eligible population of 661 neonates. The selected neonates were assigned randomly to one of three intervention groups: sucrose + nonnutritive sucking; sucrose alone; sterile water + nonnutritive sucking. Prior to standard heel lance procedures, the participants in each of the groups received their respective interventions. Pain was measured using the SATMASTER and behavioral observations of the infants’ faces, resulting in a PIPP score for each infant. The collected data were analyzed using SPSS and descriptive statistics, including RM-ANOVA, were calculated. Based on the findings, the researchers concluded that the combination of sucrose and nonnutritive sucking is the most effective and safe form of pain management during standard heel lance procedures. While the findings are specific to the neonate population studied and resulted in the identification of a basic set of best practices, the implications of this study for research and clinical practice may extend far beyond the population of neonates, ultimately providing the impetus to study the efficacy and safety of pain management practices in other populations of patients who may not be able to verbally articulate their pain during standard medical procedures. The current study provides a replicable methodology, outlines guidelines for ethical research and clinical practice, and openly identifies the study’s limitations. Based on the research framework and the theoretical postulations that resulted from the research of Gibbins et al., future researchers may be able to take this study a step further and improve pain management practice across different patient populations, thereby expanding the relevance of this study to many other nursing specialties

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Reference

Gibbins, S., Stevens, B., Hodnett, E., Pinelli, J., Ohlsson, A., & Darlington, G. (2002). Efficacy and safety of sucrose for procedural pain relief in preterm and term neonates. Nursing Research, 51(6), 375-382.