Effect of oral 25% dextrose on pain relief in newborn infants undergoing venepuncture


  • H. N. Yashwanth Raju Department of Peadiatrics, Mysore Medical College and Research Institute, Mysore, Karnataka, India
  • Rudrappa Sudha Department of Peadiatrics, Mysore Medical College and Research Institute, Mysore, Karnataka, India
  • Shwetha B. N. Department of Peadiatrics, Mysore Medical College and Research Institute, Mysore, Karnataka, India




Analgesia, Dextrose, Newborns, Pain score, Venepunture


Background: Aim of this study was to study effect of oral 25% dextrose for pain relief in newborns undergoing venepuncture.

Methods: This is a case control study conducted in NICU, Cheluvamba hospital attached to Mysore medical college and research institute during the period between September 2018 to November 2018. Babies with gestational age between 34 to 40 weeks of gestation who had clinical indication for blood sampling were included in the study. Neonates who are critically ill, suffered perinatal asphyxia and having congenital anomalies were excluded from the study. Hundred newborn babies admitted to NICU who had clinical indication for blood sampling were enrolled in the study. Study population were divided into 2 groups, dextrose (cases) and non-dextrose group (controls). The data analysis included gestational age, postnatal age, weight, sex, heart rate, oxygen saturation, crying time and behavioural pain assessment.

Results: Mean pain score, crying time and heart rate at 5 minutes of venepuncture were studied in both the groups. Mean pain score in dextrose group was 2.68 and in non-dextrose group was 7.18 with significant p value of 0.0062. Mean crying time in dextrose group was 8.98 minutes and in non-dextrose group was 42 minutes with significant p value of 0.001. Mean heart rate in dextrose group was 142 beats/minute and in non-dextrose group was 146bpm with p value of 0.08.

Conclusions: Pain in the newborns should be recognised and adequately treated. Lingual 25% dextrose can be used as safe and effective analgesia in neonates undergoing minor invasive procedures like venepuncture.


Johnston CC, Collinge JM, Henderson SJ, Anand KJ. A cross-sectional survey of pain and pharmacological analgesia in Canadian neonatal intensive care units. Clin J Pain. 1997;13:308-12.

Fitzgerald M, Beggs S. The neurobiology of pain: developmental aspects. Neurosci. 2001;7:246-57.

Maggio TJ, Gibbons MAE. Neonatal pain management in the 21st century. In: Taeusch HW, Ballard RA, Gleason CA. Avery’s diseases of the newborn. 8th ed. Philadelphia: Elsevier Saunders; 2005:438-445.

Anand KJ, Hickey PR. Pain and its effects in human neonate and fetus. N Eng J Med. 1987;317(21):1321-9.

Stevens B, McGrath P, Gibbins S, Beyene J, Breau L, Camfield C. Procedural pain in newborns at risk for neurology impairment. Pain. 2003;105:27-35.

Grunau R. Early pain in preterm infants. A model of longterm effects. Clin Perinatol. 2002;29(3):373-94.

Morison SJ, Grunau RE, Oberlander TF, Whitfield MF. Relations between behavioral and cardiac autonomic reactivity to acute pain in preterm infants. Clin J Pain. 2001;17(4):350-8.

Oliveira MJ, Tavares EC, Silva YP. Benefits and limitations of the use of glucose for treatment of pain in neonates. Rev Bras Ter Intensiva. 2011;23(2):228-37.

Shah V, Taddio A, Ohlsson A. Randomised controlled trial of paracetamol for heel prick pain in neonates. Arch Dis Child Fetal Neonatal Ed. 1998 Nov;79(3):F209-11.

Carbajal R, Lenclen R, Jugie M, Paupe A, Barton BA, Anand KJ. Morphine does not provide adequate analgesia for acute procedural pain among preterm neonates. Pediatr. 2005 Jun 1;115(6):1494-500.

Nimbalkar SM, Chaudhary NS, Gadhavi KV, Phatak A. Kangaroo Mother Care in reducing pain in preterm neonates on heel prick. Indian J Pediatr. 2013 Jan;80(1):6-10.

Ahuja VK, Daga SR, Gosavi DV, Date AM. Non-sucrose sweetener for pain relief in sick newborns. Indian J Pediatr. 2000;67:487-9.

Barr RG, Pantel MS, Young SN, Wright JH, Hendricks LA, Gravel R. The response of crying newborns to sucrose: is it a sweetness effect? Physiol Behav. 1999;66(3):409-17.

Stevens B, Yamada J, Ohlsson A. Sucrose for analgesia in newborn infants undergoing painful procedures. Cochrane Database Syst Rev. 2016 Jul;(7):CD001069.

Krechel SW, Bildner J. CRIES: a new neonatal postoperative pain measurement score. Initial testing of validity and reliability. Pediatr Anesthesia. 1995 Jan;5(1):53-61.

Anand KJS, Corr DB. The neuroanatomy, neurophysiology and neurochemistry of pain, stress and analgesia in newborns and children. Ped Clin N Am. 1989;36:795-818.

Volpe JJ. Brain injury in the premature infants – current concepts of pathogenesis and prevention. Biol Neonate. 1992;62:231-42.

Jatana SK, Dalal SS, Wilson CG. Analgesic effect of oral glucose in neonates. Med J Armed Forces India. 2003 Apr 1;59(2):100-4.

Blass EM, Hoffmeyer LB. Sucrose as an analgesic for newborn infants. Pediatr. 1991;87(2):215-8.

Ramenghi L, Wood CM, Griffiths GC, Levene MI. Reduction of pain response in premature infants using intra-oral sucrose. Arch Dis Child. 1993;69:388-9.

Ravishankar A, Thawani R, Dewan P, Das S, Kashyap A, Batra P, et al. Oral dextrose for analgesia in neonates during nasogastric tube insertion: A randomised controlled trial. J Paediatr Child Health. 2014 Feb;50(2):141-5.

Chermont AG, Falcão LF, de Souza Silva EH, Balda RD, Guinsburg R. Skin-to-skin contact and/or oral 25% dextrose for procedural pain relief for term newborn infants. Pediatr. 2009;124(6):e1101-7.

Banga S, Datta V, Rehan HS, Bhakhri BK. Effect of sucrose analgesia, for repeated painful procedures, on short-term neurobehavioral outcome of preterm neonates: a randomized controlled trial. J Tropic Pediatr. 2016 Apr 1;62(2):101-6.

Mundol TH, Prabhu AS, Saldanha PR. 25% oral dextrose as analgesia during neonatal immunisation with BCG. Inter J Contemp Pediatr. 2018 Mar;5(2):416-9.

Kavthekar S, Bharti H, Kurne A. Comparison of analgesic effect of oral 25% dextrose, 12% sucrose, 24% sucrose and placebo during 1st DPT vaccination in healthy term infants. Ind J Applied Res. 2016;6(5):2-6.

Gharehbaghi MM, Ali P. The effect of oral dextrose on pain relief of newborn infants. Pak J Med Sci. 2007 Oct 1;23(6):881.

Upadhyay A, Aggarwal R, Narayan S, Joshi M, Paul VK, Deorari AK. Analgesic effect of expressed breast milk in procedural pain in term neonates: a randomized, placebo-controlled, double-blind trial. Acta Paediatr. 2004;93:518-22.

Uyan ZS, Ozek E, Bilgen H, Cebeci D, Akman I. Effect of foremilk and hindmilk on simple procedural pain in newborns. Pediatr Int. 2005;47:252-7.

Ogawa S, Ogihara T, Fujiwara E, Ito K, Nakano M, Nakayama S, et al. Venepuncture is preferable to heel lance for blood sampling in term neonates. Archives of Disease in Childhood-Fetal and Neonatal Edition. 2005 Sep 1;90(5):F432-6.

Abad F, Diaz NM, Domenech E, Robayna M, Rico J. Oral sweet solution reduces pain-related behaviour in preterm infants. Acta Paediatr. 1996;85:854-8.






Original Research Articles