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. 2016 Jul 15;2016(7):CD001069. doi: 10.1002/14651858.CD001069.pub5

5. Trials assessing pain during subcutaneous injections.

Study Participants Procedure Interventions Outcomes Metrics used Results
Allen 1996 285 term infants
 
Various age groups based on required immunisations. Age groups were:

  1. 2 weeks (n = 50)

  2. 2 months (n = 44)

  3. 4 months (n = 50)

  4. 6 months (n = 46)

  5. 9 months (n = 28)

  6. 15 months (n = 30)

  7. 18 months (n = 37)


 
Only data for neonates at 2 weeks of age are included in this review
 
 		 Subcutaneous injection

  1. 2 mL 12% sucrose (0.24 g)

  2. 2 mL sterile water

  3. No treatment


 
The solutions were given 2 min prior to the procedure		 Cry duration (during and after procedure)  
% time crying		 The overall P value for % time crying was significant (F = 5.92, P < 0.005) for the 2‐week‐old age group. Pairwise comparisons of the % time spent crying of sucrose and water groups versus the no treatment group showed significant differences (P < 0.01 for both comparisons)
 
This was the only age group (< 2 weeks) in which significant differences were observed between sucrose, water and no treatment groups
Means and SDs were not reported. No data could be used in RevMan‐analyses
Mucignat 2004 33 preterm neonates, mean (SD) GA at birth 30 weeks (6 days), GA at injection 32 weeks (6 days) Subcutaneous injections

  1. NNS group: pacifier sucking (41 injections)

  2. Sucrose + NNS group: 0.2 mL to 0.5 mL 30% sucrose with pacifier (86 injections)

  3. EMLA + NNS group: local application of EMLA with pacifier (71 injections)

  4. Sucrose + EMLA + NNS group: 0.2 mL to 0.5 mL sucrose with EMLA and pacifier (67 injections)


Each infant was its own control		 Duration of cry from needle introduction until to 2 min after its removal
HR before injection, during injection and after injection
SpO2 before injection, during injections and after injection
DAN and NFCS scores during injection		 Mean, SD Crying time was significantly lower in the sucrose + EMLA + NNS group (P = 0.0002). The mean (SD) crying time in each group was as follows: 3.93 s (2.97) in the NNS group, 2.81 s (4.81) in the EMLA + NNS group, 2.32 s (7.51) in the sucrose + NNS group and 0.89 s (2.66) in the sucrose + EMLA + NNS group
There were no significant differences in HR between the 4 groups
The only significant difference in SpO2 between groups occurred during injection, which was lower in the NNS group (P = 0.02)
Significant reduction in DAN and NFCS scores in EMLA + NNS, sucrose + NNS, and sucrose + EMLA + pacifier groups compared to NNS alone
No data could be used in RevMan‐analyses

Abbreviations

DAN = Douleur Aiguë du Nouveau‐né Scale
 EMLA = eutectic mixture of local anaesthetics
 GA = gestational age
 HR = heart rate
 NFCS = Neonatal Facial Coding System
 NNS = non‐nutritive sucking
 SD = standard deviation
 SpO2 = oxygen saturation