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Variability in clinical practice guidelines for sweetening agents in newborn infants undergoing painful procedures

Variability in clinical practice guidelines for sweetening agents in newborn infants undergoing painful procedures

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Title: Variability in clinical practice guidelines for sweetening agents in newborn infants undergoing painful procedures
Author: Taddio, Anna
Yiu, Ashley
Smith, Ryan W
Katz, Joel
McNair, Carol
Shah, Vibhuti
Abstract: Objective: Sweetening agents have been recommended in position
statements and consensus documents for procedural pain management
in neonates; however, it is not clear if this has resulted in
widespread adoption in clinical practice. The objective of this study
was to investigate unit-specific protocols for the use of sweetening
agents.
Methods: Structured telephone survey with qualified personnel in
special care (level II) nurseries and neonatal intensive care (level
III) units across Canada. The frequency and pattern of recommended
use of sweetening agents was documented.
Results: Eighty-six of 92 units (93.5%) participated. Sixty-four
percent recommended sucrose and 2.3% recommended glucose for
procedural pain management; 87.7% had a guideline. Sweetening
agents were most commonly recommended for venipuncture/
venous cannulation (91.2% for both), lumbar puncture (87.7%),
and heel lance (82.5%). Dosing guidelines ranged from 0.05mL of
24% sucrose solution to 3mL of 25% sucrose solution. Sweeteners
were not recommended for infants with necrotizing enterocolitis
(77.2%) or those who were nil per os (75%).
Conclusions: Sweetening agents were recommended for procedural
pain management in two-thirds of special care nurseries and
neonatal intensive care units across Canada with extensive
variability in specific dosing guidelines. Audits of pain management
practices should therefore account for unit-specific practice guidelines.
Sponsor: This study was supported by a Canadian Institutes of Health Research (CIHR) research studentship to Ms A Yiu, a CIHR New Investigator Award to Dr A Taddio, and a CIHR Canada Research Chair in Health Psychology to Dr J Katz. The funding did not include any input into the design and conduct of the study; collection, management, analysis, or interpretation of data; preparation, review, or approval of manuscript. There are no conflicts of interest.
Subject: sucrose, practice guidelines, pain management, infant/ newborn
Type: Article
Rights: http://journals.lww.com/clinicalpain/pages/articleviewer.aspx?year=2009&issue=02000&article=00012&type=abstract
http://journals.lww.com/clinicalpain/pages/default.aspx
http://www.lww.com
URI: http://hdl.handle.net/10315/26495
Published: Lippincott, Williams & Wilkins
Citation: Clin J Pain. 2009 Feb;25(2):153-155.
ISSN: ISSN: 0749-8047 (print), 1536-5409 (online)
Date: 2009-02

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