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TMR Integrative Nursing  2018, Vol. 2 Issue (3): 142-147    DOI: 10.12032/TMRIN20180719
Systematic review     
Comparative efficacy of oral glucose solution versus non-nutritive sucking for pain relief in neonates during nociceptive procedures: a systematic review
Hui Liang1#, Xu Tian2#, Xiao-Ling Liu2#, Yi Dai1, Jun Geng1, Li Kang1, Zhen Li1, Li-Fen Jin1,*()
1Department of Nursing, the First People’s Hospital of Yunnan Province, Yunnan 650032, China;
2Department of gastroenterology, Chongqing University Cancer Hospital & Chongqing Cancer Institute & Chongqing Cancer Hospital, Chongqing 400030, China.;
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This systematic review was performed to objectively investigate the analgesic effect of Oral glucose solution related to non-nutritive sucking in newborns during nociceptive procedures.

Editor’s Summary

Neonatal pain could cause several negatively psychological and physical consequences. To the date, non-pharmacological and pharmacological interventions have been two primary option for reducing pain.


Background and aims: The comparative efficacy of glucose solution (GS) versus non-nutritive sucking (NNS) for pain relief in neonate remains controversial. This systematic review was consequently performed to objectively investigate the analgesic effect of Oral GS related to NNS in newborns during nociceptive procedures. Methods: All potential records were searched in PubMed, Web of Science, EMBASE, and the Cochrane Library to capture the randomized controlled trials comparing GS with NNS in terms of pain scores in neonates through January 2017. Two independent investigators screened the identified articles, extracted the data, and assessed the methodological quality of the included studies. All statistical analyses were completed by using Review Manager (RevMan) version 5.3.0.Results: Four studies, involving 248 neonates, were incorporated into these statistical analyses. For reducing pain scores, no statistical difference was detected when GS compared to NNS (4 trials; mean difference [MD], 0.75; 95% confidence interval [CI], -0.77 to 2.27; P = 0.33).Conclusion: Both the GS and NNS reduced the pain scores in neonates who undergoing Hepatitis B vaccination and venipuncture, but the NNS is more convenience than GS to some extent. Considered the limited evidences, more randomized controlled trials with high-quality, large-scale and appropriate measures time are warranted to further establish the comparative efficacy of these two options.

Key wordsNeonates      Oral glucose solution      Non-nutritive sucking      Meta-analysis     
Published: 24 September 2018
Corresponding Authors: Jin Li-Fen     E-mail:
Cite this article:

Hui Liang, Xu Tian, Xiao-Ling Liu, Yi Dai, Jun Geng, Li Kang, Zhen Li, Li-Fen Jin. Comparative efficacy of oral glucose solution versus non-nutritive sucking for pain relief in neonates during nociceptive procedures: a systematic review. TMR Integrative Nursing, 2018, 2(3): 142-147.

URL:     OR

Figure 1 Flow chart of literature retrieval and selection
Studies Country SS
Age (yrs) Pain evaluation Apgar scores Intervention regimes
Lima 2017 Brazil 40/38 ≥ 36 weeks of gestation NIPS < 5 at 5min 2 ml of 25% glucose was orally administered 2 min before cleansing of the right thigh received a gloved finger 2 min before
Mekkaoui 2012 Morocco 25/25 28-37 weeks of gestation DAN n.r. oral administration of 2 ml of glucose 30% non-nutritive sucking of a teat
Liu 2010 China 35/35 ≥ 32 weeks of gestation NIPS > 7 at both one and 5 min after birth 2 ml of 25% glucose was drawn into a syringe a standardized pacifer
Carbajal 1999 France 25/25 > 24 weeks of gestation DAN ≥ 7 at 5min 2 ml 30% glucose sucking a pacifier
Table 1 Characteristics of included studies
Figure 2 Risk of bias graph
Figure 3 Risk of bias summary
Figure 4 Meta-analysis of pain between oral GS and NNS. GC, glucose solution; NNS, non-nutritive sucking
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