EFFECTIVENESS OF ORAL SUCROSE IN DECREASING PAIN DURING ROUTINE INFANT IMMUNIZATION INJECTIONS IN AN URBAN HOSPITAL IN JOS, NIGERIA

Abstract

Background: Routine immunization injections are the most common painful procedure of childhood, for healthy infants beyond the neonatal period. This is frequently performed without analgesia, probably because of the belief that infants do not experience pain with the same intensity as adults. However, newborns have the anatomical and functional components required for perception of painful stimuli, and unmanaged pain can affect central nervous system development and may ultimately affect neurologic function. Oral sucrose, which is inexpensive, short acting, non-sedating and easily administered has been shown to be a safe and effective method of pain relief during routine immunization in young infants. Objective: To determine whether oral sucrose decreases pain response during routine infant immunization injections, with the overall purpose of recommending its use in hospitals. Methods: This was a randomized, double blind interventional study; comparing pain scores between infants who received oral sucrose and control group who received placebo before immunization injections at 6 and 14 weeks of age. Infants were randomly assigned to either treatment or control group. A full physical examination was done, with weight, heart rate, respiratory rate, oxygen saturation measured before and after the immunization. Acute behavioural pain response was quantified using the Neonatal Infant Pain Scale [NIPS] and results compared between the two groups. Results: The control and the intervention group were similar with regards to mean weight (4.67±0.5kg versus 4.66±0.7kg, p=0.922), head circumference (39.42±0.3cm versus 39.50±0.2cm, p=0.665), and length (56.41±0.3cm versus 56.34±0.7cm, p=0.343). Infants who had oral sucrose before immunization injections had lower mean NIPS score compared to the control group (5.39 ±0.9 versus 6.90 ±0.3, P = 0.001). Also, they had smaller decreases in transcutaneous oxygen levels, from 96.82±2.2 to 93.71±2.9, compared to the control group, from 96.97±1.6 to 91.74±3.1. They also had smaller increases in heart rate compared to the control group, from 134.74±3.5 to 137.27±7.8 beats per minute versus, from 133.42±7.3 to 145.00±8.6 beats per minute; and respiratory rates, from 44.29±2.4 to 46.17±4.5 compared to from 46.53±1.3 to 50.62±5.4 in the control group. Conclusion: Infants receiving oral sucrose before the immunization injections experienced significantly less pain, smaller decreases in transcutaneous oxygen levels, smaller increases in heart rate and respiratory rate than controls.