“EFFECTIVENESS OF ORAL SUCROSE SOLUTION IN REDUCTION OF PAIN AMONG INFANTS UNDERGOING PAINFUL PROCEDURE AT SELECTED HOSPITALS, ERODE

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Mrs.saranya, Dr. Prof: Jamuna rani, Mrs. M. Gayathri devi

“EFFECTIVENESS OF ORAL SUCROSE SOLUTION IN REDUCTION OF PAIN AMONG INFANTS UNDERGOING PAINFUL PROCEDURE AT SELECTED HOSPITALS, ERODE Dr. Prof: Jamuna rani1, Mrs. M. Gayathri devi2 , Mrs.Saranya.M3 1.Principal, Medical Surgical Nursing Department,(affiliated to the Tamilnadu Dr. M.G.R. Medical University, Chennai) Sre sakthimayeil Institute of Nursing and Research (JKK Nattraja Educational Institutions), Namakkal. Tamil Nadu, India. 2.Associate Professor, Child Health Nursing Department, (affiliated to the Tamilnadu Dr. M.G.R. Medical University, Chennai) Sre sakthimayeil Institute of Nursing and Research (JKK Nattraja Educational Institutions), Namakkal. Tamil Nadu, India 3.M.sc(N) Student, Sre sakthimayeil Institute of Nursing and Research (JKK Nattraja Educational Institutions),(affiliated to the Tamilnadu Dr. M.G.R. Medical University, Chennai) Namakkal. Tamil Nadu, India. Corresponding author:saranyamadhaiyan7@gmail.com ABSTRACT Background: A negative impact of pain is a consequence of a normal state of an infant. pain as ‘an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage’. The pediatric acute pain experience involves the interaction of physiologic, psychologic, behavioral, developmental, and situational factors. Non-pharmacological Interventions used to minimise pain . Oral sucrose is a safe and effective mild analgesic which is effective in decreasing short-term pain and distress during minor procedures. Small amounts of sweet solutions (oral sucrose) are placed on the infant's tongue to reduce procedural pain.24% Oral sucrose solution is one of the non-pharmacological measure which is effective in reduction of pain among infants undergoing intravenous cannulation. This study assessed the effectiveness of oral sucrose solution in reduction of pain among infants undergoing painful procedure. Objectives: The effectiveness of oral sucrose solution in reduction of pain among infants undergoing painful procedure. Design: Quasi experimental –post test only control group design Setting: Best Children's Hospital and Sudha Mother and Child Care Hospital, Erode. Sample size: Total sample size was 60. Sampling technique : The samples were selected by using purposive sampling technique. Methods: Demographic variables were collected and Post test was done for both experimental and control group by using FLACC Behavioral infant pain assessment scale . Then the intervention of Oral sucrose solution was given to the infant. In control group the existing hospital routine was practiced. Post test was assessed on FLACC Behavioral infant pain assessment scale for both experimental and control groups. Results The demographic variables age of the infant, Sex, Weight of the infant in kgs, Birth order of the infant, Supporting persons with the infant during Intravenous cannulation ,Numbers of exposure to painful procedure and Infant behavioral state before the painful procedurehad shown statistically significant association between the post-test level of pain during Intravenous cannulation among infants with selected demographic variables in experimental group. The demographic variables Sex and Weight of the infant in kgs had shown statistically significant association between the post-test level of pain during Intravenous cannulation among infants with selected demographic variables in control group. The other demographic variables had not shown statistically significant association between the post-test level of pain during Intravenous cannulation among infants with selected demographic variables in control group. Conclusion The present study assessed the Effectiveness of oral sucrose solution in reduction of pain among infants undergoing painful procedure at selected hospital, Erode. The result of this study showed that most of the infants in experimental group had reduction of pain during intravenous cannulation after administration of oral sucrose. INTRODUCTION Children experience pain just as much as adults. Children of all ages experience pain; preterm infants likely experience even more pain than an adult when subjected to same stimulus. Although management of pain has improved over last few decades ,particularly for predictable pain problems (such as postoperative pain),but under estimation and under treatment of pain in children remain problems till now. Untreated pain may have significant and lifelong physiologic and psychological consequences like altered pain sensitivity. (Parul Datta, 2022) Pain is “an unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage,” and is expanded upon by the addition of six key Notes and the etymology of the word pain for further valuable context. (IASP, 2020) Pain is always a personal experience that is influenced to varying degrees by biological, psychological, and social factors. Pain and nociception are different phenomena. Pain cannot be inferred solely from activity in sensory neurons. Through their life experiences, individuals learn the concept of pain. A person’s report of an experience as pain should be respected. Although pain usually serves an adaptive role, it may have adverse effects on function and social and psychological well-being. Verbal description is only one of several behaviors to express pain; inability to communicate does not negate the possibility that a human or a nonhuman animal experiences pain. Pain is a complex phenomenon, and its management is becoming increasingly recognized as the cornerstone of high-quality patient care . Optimizing the management of pediatric pain has been highlighted as a key healthcare priority by the World Health Organization, and leading pediatric and pain societies . Children experience multiple painful procedures daily when being cared for in hospital and ambulatory settings . With half of all emergency department (ED) visits resulting from painful conditions, and 78% of patients experiencing pain during their ED stay , EDs represent a setting where effective pediatric pain management should be an essential component of care. The most common painful procedures in the ED include venipuncture and intravenous (IV) insertions. (Kassi Shave, et al., 2018) Poorly managed pain from venipuncture and IV insertion procedures can have short-term (e.g., anxiety, avoidance behaviours, and somatic symptoms) and long-term (e.g., increased pain sensitivity, fear, healthcare avoidance as adults) impacts on a child, which can extend and complicate both the procedure and the ED stay . Physical strategies - Comfort positioning is the sitting upright, rather than the traditional approach of lying on a bed while being physically restrained, has been shown to increase children’s comfort during procedures such as IV insertion or vaccination . Sitting upright reduces distress by enhancing children’s sense of control. Smaller children may sit on their caregiver’s lap . Secure, comforting, or ‘hugging’ holds serve to assist, rather than restrain, the child . Caregivers can also help support their child with distraction and soothing words while assisting with comfort positioning . Family presence should always be encouraged, while taking caregiver preferences into account. (Evelyne D Trottier, 2019) Infant-focused strategies - Breastfeeding can be a multimodal comfort strategy, simultaneously offering skin-to-skin contact, the comfort of sucking and rocking, and (likely) the transfer of endogenous opiates in breast milk. Breastfeeding reduces procedural pain in newborns receiving heel sticks and venipunctures, as well as cry duration and pain scores during infant immunizations. Sucrose has been studied at various dosages and concentrations . For painful procedures (e.g., heel lances, venipunctures, intramuscular [IM] injections, immunization), its usefulness has been clearly shown in both preterm and term neonates . For this age group, it has similar effectiveness to breastfeeding for reducing needle pain . Sucrose may also reduce cry duration in infants 1 to 12 months of age , but there is insufficient evidence to support its use beyond 12 months . Recommended dosing varies from 0.5 mL to 2 mL of 24% to 33% sucrose. To be most effective, part of the dose must be given 2 minutes before the procedure and the rest during the procedure . Homemade solutions can be prepared by diluting 5 g of sugar (one restaurant packet) in 10 mL of water . Sucrose reduces composite pain scores by approximately 20% and is most effective when combined with other strategies. STATEMENT OF THE PROBLEM Effectiveness of oral sucrose solution in reduction of pain among infants undergoing painful procedure at selected hospital, Erode. OBJECTIVES OF THE STUDY 1. To assess the level of pain during intravenous cannulation in experimental and control group infants admitted in the selected hospital ,Erode. 2. To evaluate the effectiveness of oral sucrose among infants undergoing painful procedure like intravenous cannulation in experimental and control group. 3. To find out the association between the selected demographic variables and the post test scores of the experimental and control group infants undergoing Intravenous cannulation. MATERIALS AND METHODS: DESCRIPTION OF THE TOOL The tool was organized into two sections. Section I: Demographic Variables of the Infants. It consists of the selected demographic variable like age, sex, weight, birth order , supporting person, Numbers of exposure to painful procedure , Infant behavioral state before the painful procedure Section II: The FLACC Behavioral Pain Scale. The FLACC behavioral scale consists of five behavioral cues like face, legs, activity, cry and consolability. The maximum score for each cue is 2 and the minimum score is 0. The total score for the scale is 10. The score interpretation is given below in the table. FLACC pain score Interpretation 0 Relaxed / comfortable 1-3 Mild discomfort 4-6 Moderate discomfort 7-10 Severe discomfort/pain/both VALIDITY AND RELIABILITY OF THE TOOL VALIDITY The content validity was obtained from five experts, of which three are from the nursing field and two from the medical specialist. RELIABILITY Reliability of an instrument is the degree of consistency measures that attribute it is supposed to be measured .Reliability of the tool was estimated in the study of subjects by using Cronbach's Alpha Method. The score obtained were correlated .The overall reliability score obtained was r = 0.87.The tool was found to be reliable. PROCEDURE FOR DATA COLLECTION The period of data collection as for about 4weeks. A formal written permission was obtained from hospital to carry out the main study. A total sample of 60 infants undergoing intravenous cannulation whome the inclusion criteria. The sample was selected by non-probability purposive sampling technique,30 samples for experimental group and 30 sample for control group. The investigator had obtained individual informed oral consent from the parents of each infant who were included in the study. The information pertaining to the demographic data was collected. 24% oral sucrose solution was prepared manually by adding 24 gram ordinary sugar with 100 ml of distilled water. Data was collected in the Pediatric Ward. The 24% oral sucrose solution was instilled to 30 samples of the experimental group just before 30 seconds of Intravenous cannulation which was administered for about 2 minutes, whereas 30 samples of the control group was not instilled 24% oral sucrose solution. The pain perception of the experimental group and control group infants were obtained by using the FLACC Behavioral scale and compared with one another to evaluate the pain level over of 5 minutes. The recordings were made in the FLACC scale. SECTION A: DESCRIPTION OF THE DEMOGRAPHIC VARIABLES AMONG INFANTS IN EXPERIMENTAL AND CONTROL GROUP. Table - 4.1 Frequency and percentage distribution of demographic variables among infants in experimental and control group (N=60 (30+30)) S.NO DEMOGRAPHIC VARIABLES EXPERIMENTAL GROUP CONTROL GROUP N % N % 1 Age of the infant 7 to 8 months 11 36.7 10 33.3 9 to 10 months 13 43.3 16 53.3 11 to 12 months 6 20 4 13.4 2 Sex Male 20 66.7 18 60 Female 10 33.3 12 40 3 Weight of the infant in kgs Below 8 kgs 5 16.7 13 43.3 9 to 10 Kgs 12 40 11 36.7 11 to 12 Kgs 7 23.3 4 13.3 Above 12 kgs 6 20 2 6.7 4 Birth order of the infant First 13 43.3 9 30 Second 9 30 13 43.3 Third 8 26.7 8 26.7 5 Supporting persons with the infant during Intravenous cannulation Mother only 11 36.7 16 53.3 Parents 7 23.3 9 30 Others 12 40 5 16.7 6 Numbers of exposure to painful procedure One time 9 30 19 63.3 Two time 21 70 11 36.7 7 Infant behavioral state before the painful procedure Calm, relaxed 8 26.7 11 36.7 Distressed, fussy 13 43.3 14 46.7 Cry 9 30 5 16.6 Table 4.1 shows frequency and percentage distribution of demographic variables among infants in experimental and control group. ❖ Both in experimental 13(43.3%) and control 16(53.3%) group majority of infants were in the age group 9 to 10 months. ❖ Both in experimental 20(66.7%) and control 18(60%) group majority of infants were male. ❖ In experimental group majority of infants Weight 12(40%) were9 to 10 Kgs whereas in control group majority 13(43.3%) were below 8 kgs. ❖ In experimental group majority of infants Birth order 13(43.3%) were First whereas in control group majority 13(43.3%) were Second. ❖ In experimental group majority of infants, Supporting persons with the infant during Intravenous cannulation 12(40%) were others whereas in control group majority 16(53.3%) were Mother only. ❖ In experimental group majority of infants, Numbers of exposure to painful procedure 21(70%) were Two time whereas in control group majority 19(63.3%) were One time. ❖ Both in experimental 13(43.3%) and control 14(46.7%) group majority of infants, behavioral state before the painful procedure were Distressed, fussy. ❖ SECTION B: ASSESSMENT OF THE LEVEL OF PAIN DURING INTRAVENOUS CANNULATION AMONG INFANTS IN EXPERIMENTAL AND CONTROL GROUP. ❖ Table - 4.2 ❖ Frequency and percentage distribution of the level of pain during Intravenous cannulation among infants in experimental group. ❖ (N=30) Level of pain FREQUENCY (n) PERCENTAGE (%) Relaxed / comfortable 0 0 Mild discomfort 18 60 Moderate discomfort 12 40 Severe discomfort/pain/both 0 0 Total 30 100 Mean+Standard deviation 3.17+1.621 ❖ ❖ Table 4.2 that frequency and percentage distribution of the level of pain during Intravenous cannulation among infants in experimental group. ❖ Majority of infants 18(60%) had mild and 12(40%) had moderate level of pain and the mean and standard deviation the level of pain during Intravenous cannulation among infants is (3.17+1.621) respectively. ❖ Table - 4.3 ❖ Frequency and percentage distribution of the level of pain during Intravenous cannulation among infants in control group. ❖ (N=30) Level of pain FREQUENCY (n) PERCENTAGE (%) Relaxed / comfortable 0 0 Mild discomfort 6 20 Moderate discomfort 24 80 Severe discomfort/pain/both 0 0 Total 30 100 Mean+Standard deviation 5.37+1.217 ❖ Table 4.3 shows that frequency and percentage distribution of level of pain during Intravenous cannulation among infants in control group. ❖ Majority of infants 24(80%) had moderate and 6(20%) had mild level of pain and the mean and standard deviation the level of pain during Intravenous cannulation among infants is (5.37+1.217) respectively. SECTION C: EVALUATE THE EFFECTIVENESS OF ORAL SUCROSE AMONG INFANTS UNDERGOING PAINFUL PROCEDURE LIKE INTRAVENOUS CANNULATION IN EXPERIMENTAL AND CONTROL GROUP Table – 4.4 Evaluate the effectiveness of oral sucrose among infants undergoing painful procedure like Intravenous cannulation in experimental and control group (N=60) Group Mean Standard deviaton Mean difference ‘t’ value Paired -t test df ‘p’ VALUE Experimental Group 3.17 1.621 2.20 5.94 58 0.001 *S Control Group 5.37 1.217 ** p < 0.001 highly significant ,NS-Non Significant. Table 4.4 shows that, evaluate the effectiveness of oral sucrose among infants undergoing painful procedure like Intravenous cannulation in experimental and control group The mean score of evaluate the effectiveness of oral sucrose among infants undergoing painful procedure like Intravenous cannulation in experimentalgroup was 3.17+1.621 and the mean score in the control groupwas5.37+1.217. The calculated paired ‘t’ test value of t = 5.94shows statistically highly significant difference of evaluate the effectiveness of oral sucrose among infants undergoing painful procedure like Intravenous cannulation in experimental and control group. SECTION D: ASSOCIATION BETWEEN THE POST-TEST LEVEL OF PAIN DURING INTRAVENOUS CANNULATION AMONG INFANTS WITH SELECTED DEMOGRAPHIC VARIABLES IN BOTH EXPERIMENTAL AND CONTROL GROUP. Table 4.5 Association between the post-test level of pain during Intravenous cannulation among infants with selected demographic variables in experimental group. (N=30) SL.NO Demographic variables EXPERIMENTAL GROUP Chi-square X2 and P-Value Post-test level of pain MILD MODERATE N % N % 1 Age of the infant X2=26.52 Df=2 p =0.001 *S 7 to 8 months 0 0 11 91.7 9 to 10 months 13 72.2 0 0 11 to 12 months 5 27.8 1 8.3 2 Sex X2=14.62 Df=1 p =0.005 *S Male 9 50 11 91.7 Female 9 50 1 8.3 3 Weight of the infant in kgs X2=17.84 Df=3 p =0.001 *S Below 8 kgs 0 0 5 41.7 9 to 10 Kgs 5 27.8 7 58.3 11 to 12 Kgs 7 38.9 0 0 Above 12 kgs 6 33.3 0 0 4 Birth order of the infant X2=19.3 Df=2 p =0.001 *S First 2 11.1 11 91.7 Second 9 50 0 0 Third 7 38.9 1 8.3 5 Supporting persons with the infant during Intravenous cannulation X2=26.18 Df=2 p =0.001 *S Mother only 0 0 11 91.7 Parents 7 38.9 0 0 Others 11 61.1 1 8.3 6 Numbers of exposure to painful procedure X2=19.28 Df=1 p =0.001 *S One time 0 0 9 75 Two time 18 100 3 25 7 Infant behavioral state before the painful procedure X2=16.68 Df=2 p =0.001 *S Calm, relaxed 0 0 8 66.7 Distressed, fussy 10 55.6 3 25 Cry 8 44.4 1 8.3 *p < 0.05 significant, * *p < 0.001 Highly significant, NS-Non significant Table 4. 5 depicts that the demographic variablesAge of the infant,Sex, Weight of the infant in kgs, Birth order of the infant, Supporting persons with the infant during Intravenous cannulation ,Numbers of exposure to painful procedure and Infant behavioral state before the painful procedurehad shown statistically significant association between the post-test level of pain during Intravenous cannulation among infants with selected demographic variables in experimental group.   Table - 4.6 Association between the post-test level of pain during Intravenous cannulation among infants with selected demographic variables in control group. (N=30) SL.NO Demographic Variables CONTROL GROUP Chi-square X2 and P-Value POST-TEST LEVEL OF PAIN MILD MODERATE N % N % 1 Age of the infant X2=11.06 Df=2 p =0.071 NS 7 to 8 months 0 0 10 41.7 9 to 10 months 2 33.3 14 58.3 11 to 12 months 4 66.7 0 0 2 Sex X2=13.25 Df=1 p =0.003 *S Male 0 0 18 75 Female 6 100 6 25 3 Weight of the infant in kgs X2=12 Df=3 p =0.005 *S Below 8 kgs 0 0 13 54.2 9 to 10 Kgs 0 0 11 45.8 11 to 12 Kgs 4 66.7 0 0 Above 12 kgs 2 33.3 0 0 4 Birth order of the infant X2=6.62 Df=2 p =0.089 NS First 0 0 9 37.5 Second 0 0 13 54.2 Third 6 100 2 8.3 5 Supporting persons with the infant during Intravenous cannulation X2=6.44 Df=2 p =0.085 NS Mother only 0 0 16 66.7 Parents 1 16.7 8 33.3 Others 5 83.3 0 0 6 Numbers of exposure to painful procedure X2=7.95 Df=1 p =0.059 NS One time 0 0 19 79.2 Two time 6 100 5 20.8 7 Infant behavioral state before the painful procedure X2=8.19 Df=2 p =0.068 NS Calm, relaxed 0 0 11 45.8 Distressed, fussy 1 16.7 13 54.2 Cry 5 83.3 0 0 *p < 0.05 significant, * *p < 0.001 Highly significant, NS-Non significant Table 4.9 depicts that the demographic variablesSex and Weight of the infant in kgs had shown statistically significant association between the post-test level of pain during Intravenous cannulation among infants with selected demographic variables in control group. The other demographic variables had not shown statistically significantassociation between the post-test level of pain during Intravenous cannulation among infants with selected demographic variables in control group.   CONCLUSION The present study assessed the Effectiveness of oral sucrose solution in reduction of pain among infants undergoing painful procedure at selected hospital, Erode. The result of this study showed that most of the infants in experimental group had reduction of pain during intravenous cannulation after administration of oral sucrose. ACKNOWLEDGEMENTS We are in debt and grateful thanks to Dr. Jamuna Rani, Ph.d. Principal of sre sakthimayeil institute of nursing and research, who made us what we are now, who has given inspiration, the amenable constant and tremendous encouragement. It ‘s our great privilege to thank respected Mrs.M. 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Mrs.saranya, Dr. Prof: Jamuna rani, & Mrs. M. Gayathri devi (September-2024). “EFFECTIVENESS OF ORAL SUCROSE SOLUTION IN REDUCTION OF PAIN AMONG INFANTS UNDERGOING PAINFUL PROCEDURE AT SELECTED HOSPITALS, ERODE. INTERNATIONAL JOURNAL OF NOVEL RESEARCH AND DEVELOPMENT, 9(9), b506-b517. https://ijnrd.org/papers/IJNRD2409195.pdf

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Recently, the UGC discontinued the UGC-CARE Journal List and introduced new parameters that allow publication in Transparent Peer-Reviewed (Refereed) Journals. IJNRD is Transparent Peer Review Journal Valid As per New UGC Notification.

You can now publish your research paper in IJNRD.ORG. IJNRD is a Transparent Peer-Reviewed Open Access (Refereed Journal), UGC and UGC CARE Approved, Crossref DOI, Multidisciplinary, Impact Factor calculate by Google Scholar. As an International, open-access, and online journal, Publishing with us ensures wider reach, academic credibility, and enhanced recognition for your work.

For more details, refer to the official notice: UGC Public Notice

⭐ Low Cost ₹1570 | 📚 UGC CARE Approved | 🔍 Peer-Reviewed | 🌐 Open Access | 🔗 Crossref DOI & Global Indexing | 📊 Google Scholar Impact Factor | 🧪 Multidisciplinary

Submit Paper Online  Call for Paper  About IJNRD UGC CARE Approval

Important Dates for Current issue

Paper Submission Open For: June 2026

Current Issue: Volume 11 | Issue 6 | June 2026

Impact Factor: 8.76

Last Date for Paper Submission: Till 30-Jun-2026

Notification of Review Result: Transparent peer review process - your paper is evaluated by experts, and you receive acceptance or rejection updates via email and SMS.

Publication of Paper: Once all documents are submitted, your paper is published without delay, and you can instantly download your certificate and confirmation letter online.

Frequency: Monthly (12 issue Annually).

Journal Type: IJNRD is an international open-access journal offering Low Cost Journal Publication, transparent Peer Review Journal Publication, Crossref DOI, and multidisciplinary research visibility under UGC CARE Approved Journal Publication.

Subject Category: Research Area

Approval, Licenses and Indexing: More Details

Call For Paper - Volume 11 | Issue 6 | June 2026

IJNRD.org offers low-cost journal publication starting at ₹1570 with UGC CARE Approved, refereed, peer-reviewed, open-access publishing. This multidisciplinary monthly journal, available in both online and print formats, features a strong Google Scholar-based impact factor of 8.76, Transparent Peer Review, CrossRef DOI, global indexing, fast publication, and complete metadata for maximum research visibility and citation impact across multidisciplinary domains.

Volume 11 | Issue 6 | June 2026 | IJNRD Transparent Peer Review Certificate | Submit Paper Online till 30-Jun-2026

⭐ UGC CARE Approved Refereed Journal | 🔍 Transparent Peer Review | 🌐 Open Access Publishing | 💰 Low-Cost ₹1570 | 🔗 CrossRef DOI & Global Indexing | 📊 Google Scholar Impact Factor 8.76 | 🧪 Multidisciplinary | Online & Print

Submit Paper Online