PURPOSE: To determine the effect of nonnutritive sucking (NNS) combined with sucrose-induced analgesia on heart rate, oxygen saturation, and pain behaviors as measured by the Neonatal Infant Pain Scale (NIPS) in intubated infants.

PARTICIPANTS: Fourteen infants between the ages of 32 weeks to younger than or equal to 42 weeks were sampled by convenience from a neonatal intensive care unit.

DESIGN: Repeated-measures crossover design.

METHODS: Each infant served as his or her own control and was randomly assigned to participate first in 1 of the 2 conditions. In the treatment condition, infants were offered NNS with sucrose. In the control condition, infants were not offered any treatment. Heart rate and oxygen saturation were measured in 30-second intervals during a 5-minute baseline period, a heel stick, and a 5-minute follow-up period. Pain behaviors as scored by the NIPS were measured in 1-minute intervals during all conditions. Findings were analyzed by using a repeated-measures analysis of variance.

MAIN OUTCOME MEASURES: Heart rate significantly increased following the heel stick in the control condition; main effect F_1,13 < 46.65, P < .001; phase effect F_3,39 < 101.73, P<.001; and interaction effect F_3,39 < 24.69, P < .001. Oxygen saturation significantly decreased following the heel stick in the control condition; main effect F_1,13 < 46.65, P <= .001; phase effect, P < .001; and interaction effect P < .001. The NIPS score significantly increased following the heel stick in the control condition; phase effect F_1,13 < 697.88, P < .001.

PRINCIPAL RESULTS: Significant differences were noted between the control and intervention conditions that were clinically positive. Heart rate significantly increased following the heel stick in the control condition (mean 150.64, SD 7.53) as compared with the heart rate in the intervention condition (mean 135.64, SD 7.71). Oxygen saturation significantly decreased following the heel stick in the control condition (mean 94.30, SD 3.74) as compared with the oxygen saturation in the intervention condition (mean 97.69, SD 2.41). The NIPS score significantly increased following the heel stick in the control condition (mean 5.08, SD 0.86) as compared with the NIPS score in the intervention condition (mean 4.63, SD 0.92).

CONCLUSIONS: Infants had lower mean heart rates, higher mean oxygen saturations, and lower NIPS scores in the NNS condition with sucrose during a heel stick than those infants who were not offered NNS with sucrose.