23.

Sucrose (24%) compared with for water stress associated with echocardiography
Patient or population: neonates undergoing echocardiography Settings: hospital Intervention: sucrose (24%) Comparison: water
Outcomes	Illustrative comparative risks* (95% CI)		No of participants (studies)	Quality of the evidence (GRADE)	Comments
	Assumed risk	Corresponding risk
	No intervention	Sucrose (24%)
PIPP	The mean PIPP score was 7.4 in the control group Range of scale 0‐21 for infants < 28 weeks PMA and 0‐18 for infants > 36 weeks PMA A lower score = less pain (Stevens 1996; Stevens 2014a)	The mean PIPP score in the intervention group was lower than in the control group: ‐ 2.15 (95% CI ‐3.30 to ‐1.00)	104 (1)	⊕⊕⊝⊝ low	Bias: there were concerns about allocation concealment bias and performance blinding in this study Consistency: as this was a single study concerns about consistency were N/A Precision: this was a moderately sized study and the CI was narrow 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 PIPP 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 PIPP scores with its 95% CI'. CI: confidence interval; N/A: not applicable; PIPP: Premature Infant Pain Profile; PMA: postmenstrual age
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.