***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    Input: Background : The analgesic effect of oral sucrose in newborn infants undergoing painful procedures is generally accepted . For blood sampling , some studies have shown that venepuncture ( VP ) is less painful than heel lance ( HL ) . Objective : To determine the least painful and most effective method among blood sampling by VP or HL with or without sucrose . Design : R and omised , double blind , placebo controlled trial . Subjects : A total of 100 healthy , full term newborn infants being screened for inborn errors of metabolism were r and omly allocated to one of four experimental groups ( 25 infants in each ) . Intervention and outcome measure : Seven specially trained nurses took turns to carry out blood sampling two minutes after administration of oral sucrose or water .  Neonatal pain was assessed by the neonatal facial coding system ( NFCS ) , as well as by crying . Results : Without sucrose , the NFCS score was higher in the HL group than the VP group during blood sampling ( median 58 v 23 , p<0.001 ) . Oral sucrose significantly reduced the score of the HL group ( 58 v 47 , p<0.01 ) and also tended to reduce the score of the VP group ( 23 v 2 , p<0.1 ) . However , the HL with sucrose group still had a higher score than the VP without sucrose group ( 47 v 23 , p<0.01 ) . Crying and the total procedure time showed the same trends as the NFCS score . Conclusions : VP is less painful and more effective than HL for blood sampling in newborn infants . Although oral sucrose may have an additive analgesic effect , it is not necessarily required if VP is used for blood sampling OBJECTIVE To explore techniques that can be utilized in addition to the dorsal penile nerve block ( DPNB ) to further reduce the neonate 's stress and pain from routine circumcision , and thus make the procedure more humane . SETTING Level 1 nursery at a community hospital . SUBJECTS Eighty healthy , term , newborn male infants scheduled for routine neonatal circumcision . STUDY DESIGN Prospect i ve and r and omized ; double blind and placebo controlled for the study solutions . METHODS Four statistically similar groups of 20 were studied . The control group included infants  circumcised using : a ) a rigid plastic restraint board ; b ) st and ard DPNB ; and c ) a pacifier dipped in water to comfort the infant . Each study group differed from the controls in one variable including : 1 ) using a specially design ed , physiologic circumcision restraint chair ; 2 ) pH buffering of lidocaine hydrochloride used for DPNB ; and 3 ) offering a pacifier dipped in a 24 % sucrose solution during the DPNB and circumcision . Behavioral observations were recorded and compared for each group starting before the injection of lidocaine hydrochloride and continuing through the completion of the circumcision . Plasma for cortisol levels were collected 30 minutes after the circumcision . RESULTS Neonates circumcised on the new restraint chair showed a significant decrease in distress scores ( > 50 % ) compared with the control group on the rigid molded-plastic restraint . The pacifier dipped in sucrose had a distress-reducing effect during both the post-DPNB injection and circumcision periods . The infants who were injected with the buffered lidocaine showed no differences in distress from the controls . The plasma cortisol levels were not significantly affected by any additional technique and were comparable to the levels previously reported . CONCLUSIONS When neonatal circumcisions are performed routinely , they should be done as humanely as possible . This study demonstrates that , when used in conjunction with DPNB , a pacifier dipped in 24 % sucrose and a more comfortable , padded , and physiologic restraint can be useful in decreasing distress and pain Intraoral sucrose induces rapid and sustained calm in  crying newborns  and transiently increases mouthing and h and -mouth contact . To determine whether these effects are specific to sucrose and to explore which properties of orogustatory stimuli might contribute to this effect , 60 crying newborns were r and omized to receive 250 ul of 24 % sucrose solution , 0.25 % quinine hydrochloride solution , or corn oil as well as water in a mixed parallel crossover design . Relative to water , sucrose persistently reduced crying , and transiently increased mouthing and h and -mouth contact as previously demonstrated . While quinine produces a " disgust " face in calm infants , in crying infants it transiently decreased crying and increased mouthing , but did not affect h and -mouth contact .  Corn oil had no specific effect on crying , mouthing or h and -mouth contact . The results imply that crying newborns respond differentially to orogustatory stimuli , that taste " salience " rather than positive hedonic valence may account for initial crying reduction and increased mouthing , and that these behavioral effects are not induced by at least one lipid nutrient Abstract To study the patterns of supraspinal pain processing in neonates , we hypothesized that acute pain causes haemodynamic changes associated with activation of the primary somatosensory cortex . Forty preterm neonates at 28–36 weeks of gestation ( mean = 32.0 ) and at 25–42 h ( mean = 30.7 ) of age were studied following st and ardized tactile ( skin disinfection ) and painful ( venipuncture ) stimuli .  Changes in regional cerebral haemodynamics were monitored by near infrared spectroscopy ( NIRS ) over both somatosensory cortices in 29 newborns , and over the contralateral somatosensory and occipital areas in 11 newborns . Heart rate ( HR ) and peripheral oxygen saturation ( SaO2 ) were recorded simultaneously with NIRS parameters : oxygenated [ HbO2 ] , deoxygenated , and total hemoglobin . Tactile stimulation produced no changes in HR or SaO2 . HR increased in the first 20 s ( p < 0.001 ) , while SaO2 decreased during the 40 s after venipuncture ( p < 0.0001 ) . Following tactile or painful stimulation , [ HbO2 ] increased bilaterally regardless of which h and was stimulated ( p < 0.0001 ) . Pain‐induced [ HbO2 ] increases in the contralateral somatosensory cortex ( p < 0.05 ) were not mirrored in the occipital cortex ( p > 0.1 ) . Pain‐related [ HbO2 ] increases were more pronounced in male neonates ( p < 0.05 on left , p < 0.001 on right ) , inversely correlated with gestational age ( r = −0.53 on left , p < 0.01 ; r = −0.42 on right , p < 0.05 ) and directly correlated with postnatal age ( r = 0.75 on left , p < 0.0001 ; r = 0.67 on right , p < 0.0001 ) . Painful and tactile stimuli elicit specific haemodynamic responses in the somatosensory cortex , implying conscious sensory perception in preterm neonates . Somatosensory cortical activation occurs bilaterally following unilateral stimulation and these changes are more pronounced in male neonates or preterm neonates at lower gestational ages This experiment had three goals : 1 . To identify the basis of sucking-induced analgesia in healthy , term , newborn humans undergoing the painful , routine , procedure of heel lance and blood collection . 2 . To evaluate how taste-induced and sucking-induced analgesias combine to combat pain . 3 . To determine whether facial grimacing was an accurate index of diminished pain , or whether it was linked to tissue trauma . We report that : 1 . Sucking an unflavored pacifier was analgesic when and only when suck rate exceeded 30 sucks/min . 2 . The combination of sucrose and nonnutritive sucking was remarkably analgesic ; we saw no behavioral indication in nine of the ten infants that the heel lance had even occurred . 3 . Grimacing was reduced to almost naught by procedures that essentially eliminated crying and markedly reduced heart rate during the blood harvesting procedure There is evidence that newborn babies feel pain even at the lowest gestational ages when they can survive . Because sweet solutions such as sucrose , given orally , may relieve pain in neonates , we decided to compare the effects of two concentrations of glucose ( normally used for intravenous infusions ) and of breast milk in a r and omized controlled trial in 120 babies requiring heel‐prick tests .  Glucose solutions and breast milk are readily available in the neonatal department . No other treatment was given . Our results strongly suggest that 1 ml of a 30 % glucose solution given orally alleviates mild pain significantly and can be used for this purpose in newborns . Breast milk and 10 % glucose did not have a similar effect OBJECTIVE To determine whether milk and its components reduce  crying  in newborns during and after blood collection for phenylketonuria evaluation . METHODOLOGY Seventy-two normal newborns ingested 2 mL of milk ( Similac ) , Ross Special Formula , fat , protein , lactose , sucrose , or water for the 2 minutes preceding blood collection via heel lance . Crying duration during and for the 3 minutes after the procedure was determined by scorers who were blind to the ingestive substance . RESULTS Sucrose and Similac each reduced crying during the blood collection procedure . Sucrose , fat , protein , and Ross Special Formula were effective during the 3-minute recovery period . Neither water nor lactose were effective during or after blood collection . CONCLUSION Milk and some of its components are antinociceptive in human newborns . Based on previous studies , reduced crying during and after painful stimulation may be mediated through endogenous opioids . These findings are of potential clinical significance : natural protective mechanisms , normally engaged during suckling , may safely and noninvasively be activated to reduce  newborn crying to painful stimulation The aim of this study was to evaluate the effectiveness of different oral carbohydrate solutions for alleviation of pain in healthy preterm babies . Thirty-one preterm infants who were having blood drawn by heel prick were given 2 ml of solution A ( 20 % sucrose ) , solution B ( 20 % glucose ) or solution C ( placebo , sterile water ) into the mouth , 2 min before lancing . Behavioural responses to this painful stimulus were measured by duration of crying and facial expressions ( Neonatal Facial Coding System , NFCS ) and physiological responses were measured by heart rate ( HR ) , respiratory rate ( RR ) , and oxygen saturation changes ( SaO2 ) . Infants had a mean birth weight ( ±SD ) of 1,401 g ( 406 ) , gestational age of 30.5 weeks ( 2.7 ) ; at the time of the procedure the postmenstrual age was 32.3 weeks ( 1.5 ) . There was no significant difference in the time spent squeezing the heel between the three groups ( P = 0.669 ) . After the heel prick of both the sucrose and glucose groups the duration of first cry and total crying time was significantly reduced ( P = 0.005 and P = 0.007 ) . When the babies received placebo they showed a significantly higher NFCS score at 4 and 5 min after the heel prick ( P = 0.009 and 0.046 respectively ) . Following painful stimulus HR increased significantly in the first 3 min compared with baseline , and at the first minute the mean of the HR was found to be significantly higher in the placebo group than in the sucrose and glucose groups ( P = 0.007 ) . We concluded that both sucrose and glucose administered orally before a heel prick reduce the pain response in preterm infants BACKGROUND : Eye examinations for retinopathy of prematurity ( ROP ) are painful to the neonate . The use of topical anesthetic for eye examinations to evaluate ROP is routine in our neonatal intensive care unit ( NICU ) , but does not completely suppress painful responses . Sweet solutions have been shown to reduce procedural pain in newborns . OBJECTIVE : To examine whether the addition of sucrose 24 % to topical anesthetic improves procedural pain control during the ROP eye examination . METHODS : Neonates born at ⩽30 weeks ' gestation were included in this placebo-controlled , double-blind , crossover study . Patients were r and omly assigned to receive treatment with either proparacaine HCl ophthalmic solution 0.5 % plus 2 mL of sucrose 24 % or proparacaine HCl ophthalmic solution 0.5 % plus 2 mL of sterile water ( placebo ) prior to an eye examination . In a subsequent eye examination , each patient received the alternate treatment . Oral sucrose and sterile water were prepared in the pharmacy in identical syringes , and physicians , nurses , and pharmacists in the NICU were blinded to the treatment given . Pain was measured using the Premature Infant Pain Profile ( PIPP ) scoring system , which measures both physical and physiologic measures of pain , and the scores were simultaneously assessed by 2 study nurses . PIPP scores were recorded 1 and 5 minutes before and after the eye examination and during initial placement of the eye speculum . The same ophthalmologist performed all eye examinations . Several different definitions of a pain response were investigated . RESULTS : Twenty-three infants were studied , with 12 receiving sucrose and 11 receiving placebo  as the first treatment . For 3 of the 5 definitions of pain response , patients experienced significantly less pain at speculum insertion with sucrose than with placebo . After the 
    Output:
    
Reported adverse effects were minor and similar in the sucrose and control groups .
Sucrose is not effective in reducing pain from circumcision .
The effectiveness of sucrose for reducing pain/stress from other interventions such as arterial puncture , subcutaneous injection , insertion of nasogastric or orogastric tubes , bladder catherization , eye examinations and echocardiography examinations are inconclusive .
Sucrose is effective for reducing procedural pain from single events such as heel lance , venipuncture and intramuscular injection in both preterm and term infants .
No serious side effects or harms have been documented with this intervention .