10.

Sucrose (20%) compared with facilitated tucking for pain associated with repeated heel lances
Patient or population: neonates with pain associated with repeated heel lances Settings: hospital Intervention: sucrose (20%) Comparison: facilitated tucking
Outcomes	Illustrative comparative risks* (95% CI)		No of participants (studies)	Quality of the evidence (GRADE)	Comments
	Assumed risk	Corresponding risk
	Facilitated tucking	Sucrose (20%)
Total Bernese Pain Scale for Neonates (BPSN) during heel lance Range: The BPSN contains 9 items; 3 physiologic (HR, RR, oxygen saturation) and 6 behavioural (grimacing, body movements, crying, skin colour, sleeping patterns, consolation) items. Each item is scored on a 3 point scale (0‐3) points. Higher scores for the behavioural items and greater changes in the physiological items indicate increased pain, whereas a total score of < 11 is considered nonpainful. Cignacco 2004	The mean Total Bernese Pain Scale in the control group was 9.75	The mean Total Bernese Pain Scale was lower in the in the intervention group: MD ‐2.27 (95% CI ‐4.66 to 0.12)	48 (1)	⊕⊕⊕⊝ moderate	Bias: there was some risk of bias in this study as the intervention was not blinded Consistency: as this was a single study consistency was N/A Precision: this was a small study and the CI was wide around the point estimate Directness: the study was conducted in the target population ‐ no concerns about indirectness
Total Bernese Pain Scale for Neonates during recovery from heel lance Range: See comments above. Cignacco 2004	The mean Total Bernese Pain Scalein the control group was 5.18	The mean Total Bernese Pain Scale was lower in the intervention group: MD ‐0.31 (95% CI ‐1.72 to 1.10)	48 (1)	⊕⊕⊕⊝ moderate	Bias: There was some risk of bias in this study as the intervention was not blinded. Consistency: As this was a single study consistency was N/A. Precision: This was a small study and the CI was wide around the point estimate. Directness: The study was conducted in the target population ‐ no concerns about indirectness.
*The basis for the assumed risk was 'The mean Total Bernese Pain Scale for Neonates score in the control group according to the value reported in the Assumed risk column. The corresponding risk was the mean in the intervention group for the mean Total Bernese Pain Scale for Neonates score with its 95% CI'. CI: confidence interval; MD mean difference;N/A not applicable
GRADE Working Group grades of evidence High quality: Further research is very unlikely to change our confidence in the estimate of effect. Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low quality: We are very uncertain about the estimate.