***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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    ***EXAMPLES*** 
    Input: 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 Aim : Increases in heart rate have been widely utilized as pain responses in different studies . In a previous study , we found an increase in heart rate in newborns when they received glucose as pain relief . Other research groups have shown a smaller increase in heart rate on administration of sweet solutions . We therefore investigated the question as to whether or not oral glucose itself can cause an increased heart rate in healthy infants . Method : This was a r and omized , controlled , double‐blind study comprising 70 healthy newborns . They were r and omly allocated to receive 1 ml 30 % glucose or 1 ml placebo solution ( sterile water ) orally without undergoing any painful procedure . The heart rate was recorded during and at different times after this administration . Results : The heart rate was significantly higher in the glucose than in the placebo group ( p=0.020 ) . The highest heart rate was noted during treatment , and the heart rate subsequently decreased in both groups ( p = 0.002 ) 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 The objective of this study was to assess the efficacy and safety of oral 30 % dextrose during  venepuncture in neonates . Neonates admitted in the Special Care Nursery for jaundice from September 200 to January 2001 were recruited for this double-blind r and omised controlled trial . The intervention consisted of administration of either 2 ml of oral 30 % dextrose or 2 ml of sterile water 2 minutes before venepuncture . The primary outcome measure was the cumulative Neonatal Infant Pain Scale ( NIPS ) score at 3 minutes after venepuncture and the duration of cry assessed from a videotaped recording . Twenty-six neonates received 30 % dextrose and 26 neonates received sterile water .  The cumulative NIPS score at 3 minutes ( median , IQR ) after venepuncture for neonates given 30 % dextrose ( 13 , 6.8 - 21 ) was significantly ( p = 0.03 ) lower than that for neonates given sterile water ( 21 , 13.8 - 21 ) . The duration of cry in neonates given 30 % dextrose ( median 45 sec IQR 1.5 - 180.8 sec ) was significantly ( p = 0.03 ) shorter than that in neonates given sterile water ( median 191 sec IQR 52.3 - 250 sec ) . No neonates developed diarrhoea , fever or rash during the 24 hour observation period . Both the intra-rater ( ICC 0.993 95 % CI 0.988 - 0.996 ) and inter rater ( ICC 0.988 95 % CI 0.980 - 0.993 ) agreement on the 3-minute NIPS score were good . In conclusion oral 30 % dextrose given 2 minutes before venepuncture was effective in reducing neonatal pain following venepuncture . It is a simple , safe and fast acting analgesic and should be considered for minor invasive procedure in term neonates AIM To compare the efficacies of non-nutritive sucking and glucose solution as pain-relief interventions for neonates undergoing a venipuncture procedure . BACKGROUND Neonates may be subjected to painful procedures . The individual efficacies of non-nutritive sucking or oral glucose solution used alone on pain-relief for neonates still remain controversial . DESIGN A r and omised , parallel-group controlled trial was design ed . METHODS A total of 105 neonates were r and omly assigned to one of the three groups : non-nutritive sucking , glucose solution , or control group . When a neonate underwent a venipuncture during a newborn screening test , his/her pain manifestations were videotaped and subsequently measured using the Neonatal Infant Pain Scale . Both the stability analysis and the analysis of repeated relationships were performed by generalised estimating equations . RESULTS The level of pain was regressed over the study variables ( time and group ) and covariate ( gestational age ) . Both the non-nutritive sucking and glucose solution groups had significantly lower pain scores than the control group during the venipuncture and recovery phases . Furthermore , non-nutritive sucking seemed to be more effective than glucose solution . CONCLUSION Nurses can use a pain assessment tool and the pain-relief intervention to improve the quality of neonatal care in clinical practice . This study indicates that either non-nutritive sucking or glucose solution can effectively decrease the level of pain . RELEVANCE TO CLINICAL PRACTICE If a painful procedure on neonates is inevitable , simple , convenient and effective pain-relief methods such as non-nutritive sucking or glucose solution can be provided alone . Based on a neonate 's condition , nurses can provide 2 ml of 25 % glucose solution through a syringe for a breastfeeding infant before an invasive procedure if nipple confusion is the concern AIM The aim of this study was to determine whether oral glucose could have a pain-relieving effect during the eye examinations that premature neonates undergo in the screening for retinopathy of prematurity . BACKGROUND Studies have shown that orally administered sweet-tasting solutions reduce signs of pain during painful procedures such as venepuncture and heel sticks on premature and full-term infants . This effect has not yet been proven during the eye examinations for the screening of retinopathy of prematurity . Design . R and omised , controlled , double-blind study . METHOD Thirty infants born before 32 weeks of gestation and /or weighing < 1500 g at birth were r and omised to receive 1 ml of either 30 % glucose or sterile water before the eye examination . Examinations were videotaped , and the observer was blinded to the intervention . Pain responses were scored using the premature infant pain profile . Heart rate and crying time were also recorded . RESULTS There were no statistically significant differences between the two groups , neither in premature infant pain profile score , heart rate changes nor crying time . CONCLUSION This study does not support the pain-relieving effect of orally administered glucose during eye examinations in preterm infants . RELEVANCE TO CLINICAL PRACTICE Oral glucose should not be used as single measure for pain relief during eye examinations of preterm infants . Other comforting and pain-relieving measures should be used Oral glucose was recommended as pain therapy during  venepuncture in neonates . It is unclear whether this intervention reduces excess oxygen consumption ( V˙o2 ) , energy loss , or cardiovascular destabilization associated with venepuncture , and whether < 2 mL glucose solution is effective . We tested the hypothesis that oral glucose solution attenuates the increases in neonatal oxygen consumption , energy expenditure ( EE ) , and heart rate associated with venepuncture for two different volumes of glucose solution ( 2 and 0.4 mL ) . In this prospect i ve , r and omized , controlled , double-blind trial , 58 neonates ( gestational age , 31–42 wk ; postnatal age , 1–7 d ) were r and omized to 2 mL glucose 30 % , 0.4 mL glucose 30 % , or 2 mL water by mouth before venepuncture . The videotaped behavioral pain reactions were scored with the Premature Infant Pain Profile . Cry duration , V˙o2 , EE ( indirect calorimetry ) , and heart rate were measured . The 2 mL glucose  solution reduced pain score and crying after venepuncture compared with controls [ median pain score , 5.5 ( interquartile range , 4–9 ) versus 11 ( 7–12 ) , p = 0.01 ; median duration of first cry , 0 s ( 0–43 s ) versus 13 s ( 2–47 s ) , p < 0.05 , respectively ] . The 0.4 mL glucose solution had no effect . The 2 mL glucose solution did not attenuate the V˙o2 increase during venepuncture ( 1.5 ± 0.2 mL/kg min ( water ) versus 1.7 ± 0.5 ( 0.4 mL glucose ) versus 1.1 ± 0.2 ( 2 mL glucose ) ( mean ± SEM ) nor EE nor heart rate . We conclude that oral administration of 2 mL glucose 30 % before venepuncture reduced pain expression and crying , but did not prevent the rise in V˙o2 , EE , or heart rate . Alternative therapies against the stress of nonpainful h and ling during venepuncture should be explored OBJECTIVE Inadequate assessment of  pain in premature infants is a persistent clinical problem . The objective of this research was to develop and vali date a measure for assessing pain in premature infants that could be used by both clinicians and research ers . DESIGN The  Premature Infant Pain Profile ( PIPP ) was developed and vali date d using a prospect i ve and retrospective design . Indicators of pain were identified from clinical experts and the literature . Indicators were retrospectively tested using four existing data sets . PATIENTS AND SETTING S Infants of varying gestational ages undergoing different painful procedures from three different setting s were utilized to develop and vali date the measure . METHODS AND RESULTS The largest data set ( n = 124 ) was used to develop the PIPP . The development process included determining the factor structure of the data , developing indicators and indicator scales and establishing internal consistency . The remaining three data sets were utilized to establish beginning construct validity . CONCLUSIONS The PIPP is a newly developed pain assessment measure for premature infants with beginning content and construct validity . The practicality and feasibility for using the PIPP in clinical practice will be determined in prospect i ve research in the clinical setting The objectives of this study were to measure pain symptoms in healthy fullterm newborns undergoing routine blood sampling with different methods . The 120 study subjects were r and omly allocated to one of four groups with 30 babies in each , namely venepuncture or heel stick , with or without oral glucose administration .  Pain was assessed from the duration of crying within the first 3 min , the Premature Infant Pain Profile ( PIPP ) and changes in heart rate . When the babies received 1 ml 30 % glucose prior to skin puncture there was no significant difference between the heel stick and venepuncture group either in mean crying time ( 12.9 and 11.6 s , respectively ) or in PIPP score ( 3.9 and 3.3 ) . When no glucose was given crying time was 57.3 s in the heel stick group and 26.8 s in the venepuncture group ( P = 0.0041 ) and the mean PIPP scores were 8.4 and 6.0 , respectively ( P = 0.0458 ) . This study suggests that if oral glucose is given prior to skin puncture the choice of blood sampling method has no impact on the pain symptoms To assess the characteristics of sucrose as a pain-reducing substance , crying in 72 newborn humans during and after blood collection via heel prick was determined . In the first study infants drank 2 ml of water or 2 
    Output:
    
The present systematic review and meta-analyses demonstrate that glucose reduces pain scores and crying during single heel lances and venipunctures .
Results indicate that 20 % to 30 % glucose solutions have analgesic effects and can be recommended as an alternative to sucrose for procedural pain reduction in healthy term and preterm neonates