The safety and efficacy of oral dextrose for relieving pain following venepuncture in neonates.

Pain as defined by the International Association for the Study of Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage l . As babies cannot verbalise the sensation of pain, their plight is often neglected and unattended to during painful procedures. Pain research in the last decade has established that neonates as small as 24 weeks of gestation can experience pain'. Factors which may affect the neonate response to pain are maturation of the central nervous system, state of the alertness, duration and type of painful stimuli, the environment and general state of health'. Eutectic Mixture of Local Anaesthesia (EMLA) is a commonly used topical anaesthetic in children. However, its slow onset action and its potential toxicity, Le. methaemoglobinemia in infants less than 3 months of age,' makes it impractical to use in the neonatal intensive care unit. Most painful procedures in neonates require a fast and short acting analgesia. This requirement can be met by the use of oral sucrose'. However, most studies done so far were related to the use of oral sucrose in heelprick procedures, rather than in venepunctures. The use of sucrose is inconvenient, as a fresh mixture needs to be made regularly to ensure sterility. Studies using commonly available sweet solution such as dextrose are few. Skogsdal el at has