THE INFLUENCE OF GESTATIONAL AGE ON THE EFFICACY AND SHORT-TERM SAFETY OF SUCROSE FOR PROCEDURAL PAIN RELIEF
Bibliographic record
Abstract
BACKGROUND: Physiologic and behavioral responses to procedural pain are influenced by gestational age (GA). Compared with term neonates, hospitalized preterm neonates are subjected to more painful procedures aimed at improving their clinical outcome. Although several trials to determine the efficacy of sucrose for managing procedural pain have been conducted, none have examined the influence of GA. OBJECTIVES: To examine the influence of GA on the efficacy and short-term safety of oral sucrose for relieving procedural pain associated with heel lances. To explore GA differences in behavioral and physiologic indicators of pain. METHODS: As part of a larger randomized controlled trial (RCT) to examine the efficacy and safety of sucrose during heel lance, 190 neonates were stratified by GA: (a) 27 to 316/7 weeks (group 1; n = 63), (b) 32 to 356/7 weeks (group 2; n = 63), and (c) >36 weeks (group 3; n = 64). They were then randomized to receive (a) oral sucrose and non-nutritive sucking (NNS), (b) sucrose alone, or (c) sterile water and NNS (control) for a heel lance. The influence of GA was determined by examining the short-term safety, as defined by the number of associated adverse events (choking, coughing or vomiting, sustained tachycardia, sustained tachypnea or dyspnea, or sustained oxygen desaturation). The efficacy was measured by changes in a validated pain measure, scored during each phase of the intervention and analyzed according to GA groups. RESULTS: Significant differences in pain response existed in each GA group, with the lowest mean pain scores in the sucrose and NNS group. Significant GA differences in behavioral and physiologic responses were found, with the most mature neonates demonstrating the greatest magnitude of pain response. The greatest number of short-term adverse effects to treatment occurred in the lowest GA group. CONCLUSIONS: In a secondary analysis of a larger RCT, sucrose and NNS was the most efficacious intervention for single heel lances in each of 3 GA groups. However, infants of lower GA experienced more adverse events. Research on the efficacy and safety of repeated doses of oral sucrose, tested in infants from a wide range of GA, is required.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.011 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".