By Daniel M. Lindberg, MD
Dr. Lindberg is an associate editor with NEJM Journal Watch Emergency Medicine, from which this story was adapted.
Evidence that sweet solutions improve pain for neonates during painful procedures has been compelling for more than a decade, according to a meta-analysis in Pediatrics.
Using a robust search strategy, researchers identified 168 randomized, controlled trials of oral sweet solutions for procedural pain control in neonates.
Pooled results showed that sweet solutions reduced crying time by a mean of 23 seconds and improved pain scores by a mean of 0.90 points. The cumulative results became statistically significant in 1999 for pain scores and in 2002 for crying time, yet dozens of studies have been performed since then.
Comment: At some point, it is unethical to ignore evidence that is clear and convincing. Sweet solutions improve crying time and pain scores for neonates, have virtually no untoward effects, and should be used for painful procedures. Future trials should not include a placebo arm.