Be Sweet to Hospitalized Toddlers During Venipuncture: A Randomized Controlled Trial of Sucrose Compared to Water

Objectives High-quality evidence demonstrates analgesic effects of sweet tasting solutions for infants during painful procedures. However, evidence of the analgesic effects of sucrose beyond 12 months of age is less certain. The aim of this study was to ascertain the efficacy of oral sucrose in hospitalized toddlers (ages 12 to 36▒mo) compared to placebo (water) during venipuncture. Methods Blinded, two-armed randomized controlled trial (RCT) including hospitalized toddlers aged 12-36 months. Toddlers were randomized to either 25% sucrose or water prior to venipuncture, stratified by age (12-24▒mo and >24-36▒mo). Standard of care included topical anesthetics for both groups. Pain assessment included cry duration and FLACC (Face, Legs, Activity, Cry, Consolability) scores. Descriptive statistics and linear models were used to report the percentage of time crying and mean differences in FLACC scores. Data analysis was performed using R version 3.6.3. Results A total of 95 toddlers were randomized and 85 subsequently studied. The median percentage of time spent crying between insertion of the first needle and 30s after the end of procedure in both groups was 81% (IQR=66). There was no significant difference in crying time and FLACC scores between groups (P>0.05). When examining effects of sucrose for the younger toddlers (less than 24 months of age) there was a reduction in crying time of 10% and a 1.2-point reduction in mean FLACC scores compared to the toddlers older than 24 months. Discussion Findings highlight that toddlers become highly distressed during venipuncture, despite the standard care of topical anesthetics. In addition, sucrose does not effectively reduce distress especially in the older group of toddlers.