الفهرس 
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Abstract
Preterm infants can develop a range of problems because their organs are not mature. An unfavorable environment in the NICU can be added to these problems and negatively affect their growth. They are exposed to varied sources of pain and stress. They are exposed to about 134 painful procedures within the first two weeks of life. There is now evidence that premature babies not only respond to painful stimuli, but may be even more sensitive to these stimuli than adults and vulnerable to long term effects (Cignacco et al., 2006).
Preterm and acutely ill term neonates who are hospitalized in a neonatal intensive care unit are subjected to multiple frequent invasive and painful procedures aimed at improving their outcome. Although several trials to determine the efficacy of sucrose for managing procedural pain in preterm and acutely ill term neonates have been developed, these have generally lacked methodological rigor and have not provided clinicians with clear practice guidelines (Gibbinns et al., 2002).
The present study aimed to assess efficacy of oral sucrose as non pharmacologic pain relief tool in preterm neonates in NICU.
This study was conducted on 20 preterm neonates with gestational age < 34 wks, birth weight < 1.8 kg and was studied during the 1st 10 days post natal age. Their mean gestational age (31.9 ± 1.3) weeks, mean birth weight (1.5 ± 0.13) kg. Male/ female were 8/12, 6 of them vaginally delivered and 14 were delivered by cesarean section. All 20 preterm neonates were studied with venipuncture as control group without oral sucrose intake, then the same neonatal group was studied as study group with the same venipuncture but with oral sucrose intake after 24 to 48 hours at the same time of the day (9.00 pm) to avoid diurnal variations of serum cortisol.
Preterm neonates included in the study were subjected to detailed history taking including maternal & obstetric history, perinatal history, thorough clinical examination and laboratory investigations including CBC & CRP.
Pain response was assessed by serum cortisol level by competitive chemiluminescent enzyme immunoassay (µg/dl) at time of venipuncture and after 30 minutes of venipuncture, vital data (heart rate, respiratory rate, oxygen saturation and blood pressure) and behaveioral response (first and total cry time). The preterm neonates were assessed without oral sucrose, then after 24 to 48 hours with 2 ml oral sucrose 24 % given before the painful procedure.
The preterm neonates, when they received oral sucrose before venipuncture, showed low pain response through less increase in heart rate, less oxygen desaturation, short first and total cry time and less increase in serum cortisol level compared to when they didn’t receive oral sucrose intake.
Body weight and gestation age were not correlated to cortisol level before the painful procedure in preterm neonates both when they received and didn’t receive oral sucrose. Also, cortisol level after 30 minutes was not correlated to the duration of first cry and total cry time.
Serum cortisol level was significantly negatively correlated with respiratory rate in neonates with and without oral sucrose intake. Also serum cortisol was inversely correlated with blood pressure in neonates without oral sucrose.