Oral Sucrose in Infants Undergoing Flexible Nasolaryngoscopy: A Blinded Randomized Pilot Study
Introduction Flexible nasolaryngoscopy (FNL) is a common, uncomfortable procedure performed to assess the upper airway in infants. Oral sucrose is used during various painful procedures in infants but has not been used during FNL. Our objective was to understand the impact of oral sucrose on discomf...
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| Veröffentlicht in: | The Laryngoscope 2024-08, Vol.134 (8), p.3826-3831 |
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| creator | Wolter, Nikolaus E. Tepsich, Meghan E. Daien, Ellie S. Levinsky, Justin T. Vanderpost, Mary‐Elizabeth Propst, Evan J. Siu, Jennifer M. |
| description | Introduction
Flexible nasolaryngoscopy (FNL) is a common, uncomfortable procedure performed to assess the upper airway in infants. Oral sucrose is used during various painful procedures in infants but has not been used during FNL. Our objective was to understand the impact of oral sucrose on discomfort in infants undergoing FNL.
Methods
Infants ( |
| doi_str_mv | 10.1002/lary.31371 |
| format | Article |
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Flexible nasolaryngoscopy (FNL) is a common, uncomfortable procedure performed to assess the upper airway in infants. Oral sucrose is used during various painful procedures in infants but has not been used during FNL. Our objective was to understand the impact of oral sucrose on discomfort in infants undergoing FNL.
Methods
Infants (<12‐months‐old) undergoing FNL in the otolaryngology clinic were randomized to treatment (0.5 mL 24% oral sucrose) or standard management (no sucrose). Sucrose was administered <2 min prior to FNL performed by a single endoscopist. Outcome measures included: EVENDOL pain scale and cry duration and visit duration. Infant discomfort was measured by a second observer who was blinded to treatment group.
Results
Forty‐seven infants were included, 23 were treated with sucrose and 24 with standard management. The median (IQR) age was 3.0 (2–5.7) months. There were no significant differences in age, weight, or sex across groups. The median (IQR) duration of FNL was 35.2 (26.5–58.4) and 36.4 (28.9–51.8) seconds for treatment and standard management groups, respectively. Mean (SD) EVENDOL scores were significantly lower in the sucrose group [4.9 (2.0)] than standard group (6.7 [2.1]) (p = 0.003). Mean cry duration after FNL was significantly shorter in the sucrose group (29.9 [20.4] seconds) than the standard group (52.7.0 [40.6] seconds) (p = 0.02). Median (IQR) visit duration did not differ across groups (1.1 [0.9–1.3] vs. 1.1 [0.7–1.4] h [p = 0.15]).
Conclusion
Oral sucrose given before FNL reduced EVENDOL scores and cry duration after FNL and did not prolong clinic visits in this randomized pilot study.
Level of Evidence
2 Laryngoscope, 134:3826–3831, 2024
Flexible nasolaryngoscopy is a painful procedure performed on infants. Painful procedures are often undertreated in infants due to lack of physician awareness and time constraints and this has long‐term implications on children. Oral sucrose given 2 min before flexible endoscopy successfully treated pain and did not prolong clinic visit duration.</description><identifier>ISSN: 0023-852X</identifier><identifier>ISSN: 1531-4995</identifier><identifier>EISSN: 1531-4995</identifier><identifier>DOI: 10.1002/lary.31371</identifier><identifier>PMID: 38415844</identifier><language>eng</language><publisher>Hoboken, USA: John Wiley & Sons, Inc</publisher><subject>Administration, Oral ; Crying ; Female ; flexible nasolaryngoscopy ; Humans ; Infant ; Laryngoscopy - adverse effects ; Laryngoscopy - methods ; Male ; pain ; pain management ; Pain Measurement ; Pilot Projects ; Single-Blind Method ; Sucrose ; Sucrose - administration & dosage</subject><ispartof>The Laryngoscope, 2024-08, Vol.134 (8), p.3826-3831</ispartof><rights>2024 The American Laryngological, Rhinological and Otological Society, Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c3161-353b93b3298f4d268f86df88b4220d3f336db5d291f54c03c15b5b892f74dd33</cites><orcidid>0000-0002-8013-8530 ; 0000-0002-5196-6150</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Flary.31371$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Flary.31371$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38415844$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wolter, Nikolaus E.</creatorcontrib><creatorcontrib>Tepsich, Meghan E.</creatorcontrib><creatorcontrib>Daien, Ellie S.</creatorcontrib><creatorcontrib>Levinsky, Justin T.</creatorcontrib><creatorcontrib>Vanderpost, Mary‐Elizabeth</creatorcontrib><creatorcontrib>Propst, Evan J.</creatorcontrib><creatorcontrib>Siu, Jennifer M.</creatorcontrib><title>Oral Sucrose in Infants Undergoing Flexible Nasolaryngoscopy: A Blinded Randomized Pilot Study</title><title>The Laryngoscope</title><addtitle>Laryngoscope</addtitle><description>Introduction
Flexible nasolaryngoscopy (FNL) is a common, uncomfortable procedure performed to assess the upper airway in infants. Oral sucrose is used during various painful procedures in infants but has not been used during FNL. Our objective was to understand the impact of oral sucrose on discomfort in infants undergoing FNL.
Methods
Infants (<12‐months‐old) undergoing FNL in the otolaryngology clinic were randomized to treatment (0.5 mL 24% oral sucrose) or standard management (no sucrose). Sucrose was administered <2 min prior to FNL performed by a single endoscopist. Outcome measures included: EVENDOL pain scale and cry duration and visit duration. Infant discomfort was measured by a second observer who was blinded to treatment group.
Results
Forty‐seven infants were included, 23 were treated with sucrose and 24 with standard management. The median (IQR) age was 3.0 (2–5.7) months. There were no significant differences in age, weight, or sex across groups. The median (IQR) duration of FNL was 35.2 (26.5–58.4) and 36.4 (28.9–51.8) seconds for treatment and standard management groups, respectively. Mean (SD) EVENDOL scores were significantly lower in the sucrose group [4.9 (2.0)] than standard group (6.7 [2.1]) (p = 0.003). Mean cry duration after FNL was significantly shorter in the sucrose group (29.9 [20.4] seconds) than the standard group (52.7.0 [40.6] seconds) (p = 0.02). Median (IQR) visit duration did not differ across groups (1.1 [0.9–1.3] vs. 1.1 [0.7–1.4] h [p = 0.15]).
Conclusion
Oral sucrose given before FNL reduced EVENDOL scores and cry duration after FNL and did not prolong clinic visits in this randomized pilot study.
Level of Evidence
2 Laryngoscope, 134:3826–3831, 2024
Flexible nasolaryngoscopy is a painful procedure performed on infants. Painful procedures are often undertreated in infants due to lack of physician awareness and time constraints and this has long‐term implications on children. Oral sucrose given 2 min before flexible endoscopy successfully treated pain and did not prolong clinic visit duration.</description><subject>Administration, Oral</subject><subject>Crying</subject><subject>Female</subject><subject>flexible nasolaryngoscopy</subject><subject>Humans</subject><subject>Infant</subject><subject>Laryngoscopy - adverse effects</subject><subject>Laryngoscopy - methods</subject><subject>Male</subject><subject>pain</subject><subject>pain management</subject><subject>Pain Measurement</subject><subject>Pilot Projects</subject><subject>Single-Blind Method</subject><subject>Sucrose</subject><subject>Sucrose - administration & dosage</subject><issn>0023-852X</issn><issn>1531-4995</issn><issn>1531-4995</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kMtOGzEUQC3UioTHph9QWeqmQhqwfe2Jh12KoEWKCiJBgk2tmbEdOXLsdJxRCV-P09AuWLDylXx07HsQ-kTJKSWEnfm625wChRHdQ0MqgBa8qsQHNMyXUEjBHgboIKUFIXQEguyjAUhOheR8iH7ddLXH077tYjLYBXwdbB3WCd8Hbbp5dGGOr7x5co03-Ged4vaxMI-pjavNOR7jb95lUuO7Oui4dM95vHU-rvF03evNEfpoa5_M8et5iGZXl7OLH8Xk5vv1xXhStEBLWoCApoIGWCUt16yUVpbaStlwxogGC1DqRmhWUSt4S6ClohGNrJgdca0BDtHXnXbVxd-9SWu1dKk13tfBxD4pVmU1z-uTjH55gy5i34X8OQVkVBHGSkozdbKjtl1SZ6xadW6ZV1eUqG10te2g_kbP8OdXZd8sjf6P_qucAboD_jhvNu-o1GR897iTvgCbH4uC</recordid><startdate>202408</startdate><enddate>202408</enddate><creator>Wolter, Nikolaus E.</creator><creator>Tepsich, Meghan E.</creator><creator>Daien, Ellie S.</creator><creator>Levinsky, Justin T.</creator><creator>Vanderpost, Mary‐Elizabeth</creator><creator>Propst, Evan J.</creator><creator>Siu, Jennifer M.</creator><general>John Wiley & Sons, Inc</general><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-8013-8530</orcidid><orcidid>https://orcid.org/0000-0002-5196-6150</orcidid></search><sort><creationdate>202408</creationdate><title>Oral Sucrose in Infants Undergoing Flexible Nasolaryngoscopy: A Blinded Randomized Pilot Study</title><author>Wolter, Nikolaus E. ; Tepsich, Meghan E. ; Daien, Ellie S. ; Levinsky, Justin T. ; Vanderpost, Mary‐Elizabeth ; Propst, Evan J. ; Siu, Jennifer M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3161-353b93b3298f4d268f86df88b4220d3f336db5d291f54c03c15b5b892f74dd33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Administration, Oral</topic><topic>Crying</topic><topic>Female</topic><topic>flexible nasolaryngoscopy</topic><topic>Humans</topic><topic>Infant</topic><topic>Laryngoscopy - adverse effects</topic><topic>Laryngoscopy - methods</topic><topic>Male</topic><topic>pain</topic><topic>pain management</topic><topic>Pain Measurement</topic><topic>Pilot Projects</topic><topic>Single-Blind Method</topic><topic>Sucrose</topic><topic>Sucrose - administration & dosage</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Wolter, Nikolaus E.</creatorcontrib><creatorcontrib>Tepsich, Meghan E.</creatorcontrib><creatorcontrib>Daien, Ellie S.</creatorcontrib><creatorcontrib>Levinsky, Justin T.</creatorcontrib><creatorcontrib>Vanderpost, Mary‐Elizabeth</creatorcontrib><creatorcontrib>Propst, Evan J.</creatorcontrib><creatorcontrib>Siu, Jennifer M.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>The Laryngoscope</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wolter, Nikolaus E.</au><au>Tepsich, Meghan E.</au><au>Daien, Ellie S.</au><au>Levinsky, Justin T.</au><au>Vanderpost, Mary‐Elizabeth</au><au>Propst, Evan J.</au><au>Siu, Jennifer M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Oral Sucrose in Infants Undergoing Flexible Nasolaryngoscopy: A Blinded Randomized Pilot Study</atitle><jtitle>The Laryngoscope</jtitle><addtitle>Laryngoscope</addtitle><date>2024-08</date><risdate>2024</risdate><volume>134</volume><issue>8</issue><spage>3826</spage><epage>3831</epage><pages>3826-3831</pages><issn>0023-852X</issn><issn>1531-4995</issn><eissn>1531-4995</eissn><abstract>Introduction
Flexible nasolaryngoscopy (FNL) is a common, uncomfortable procedure performed to assess the upper airway in infants. Oral sucrose is used during various painful procedures in infants but has not been used during FNL. Our objective was to understand the impact of oral sucrose on discomfort in infants undergoing FNL.
Methods
Infants (<12‐months‐old) undergoing FNL in the otolaryngology clinic were randomized to treatment (0.5 mL 24% oral sucrose) or standard management (no sucrose). Sucrose was administered <2 min prior to FNL performed by a single endoscopist. Outcome measures included: EVENDOL pain scale and cry duration and visit duration. Infant discomfort was measured by a second observer who was blinded to treatment group.
Results
Forty‐seven infants were included, 23 were treated with sucrose and 24 with standard management. The median (IQR) age was 3.0 (2–5.7) months. There were no significant differences in age, weight, or sex across groups. The median (IQR) duration of FNL was 35.2 (26.5–58.4) and 36.4 (28.9–51.8) seconds for treatment and standard management groups, respectively. Mean (SD) EVENDOL scores were significantly lower in the sucrose group [4.9 (2.0)] than standard group (6.7 [2.1]) (p = 0.003). Mean cry duration after FNL was significantly shorter in the sucrose group (29.9 [20.4] seconds) than the standard group (52.7.0 [40.6] seconds) (p = 0.02). Median (IQR) visit duration did not differ across groups (1.1 [0.9–1.3] vs. 1.1 [0.7–1.4] h [p = 0.15]).
Conclusion
Oral sucrose given before FNL reduced EVENDOL scores and cry duration after FNL and did not prolong clinic visits in this randomized pilot study.
Level of Evidence
2 Laryngoscope, 134:3826–3831, 2024
Flexible nasolaryngoscopy is a painful procedure performed on infants. Painful procedures are often undertreated in infants due to lack of physician awareness and time constraints and this has long‐term implications on children. Oral sucrose given 2 min before flexible endoscopy successfully treated pain and did not prolong clinic visit duration.</abstract><cop>Hoboken, USA</cop><pub>John Wiley & Sons, Inc</pub><pmid>38415844</pmid><doi>10.1002/lary.31371</doi><tpages>6</tpages><orcidid>https://orcid.org/0000-0002-8013-8530</orcidid><orcidid>https://orcid.org/0000-0002-5196-6150</orcidid></addata></record> |
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| subjects | Administration, Oral Crying Female flexible nasolaryngoscopy Humans Infant Laryngoscopy - adverse effects Laryngoscopy - methods Male pain pain management Pain Measurement Pilot Projects Single-Blind Method Sucrose Sucrose - administration & dosage |
| title | Oral Sucrose in Infants Undergoing Flexible Nasolaryngoscopy: A Blinded Randomized Pilot Study |
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