Date of Award


Degree Type

Selective Evidence-Based Medicine Review

Degree Name

Master of Science in Health Sciences - Physician Assistant


Physician Assistant Studies

Department Chair

John Cavenagh, MBA, PhD, PA-C


OBJECTIVE: “The objective of this selective EBM review is to determine whether or not nonnutritive sucking is an effective method of providing analgesia to infants undergoing painful procedures.”

STUDY DESIGN: A systematic review of three blinded randomized-controlled trials (RCT’s), published from 2011 to 2013. All were published in English, one of which was translated from its original Spanish version to an English publication. DATA

SOURCES: Three RCT’s were found using the PubMed database and all were published in peer-reviewed journals.

OUTCOMES MEASURED: The incidence and severity of pain were measured during procedures using the Premature Infant Pain Profile (PIPP) and/or Neonatal Infant Pain Scores (NIPS).

RESULTS: The first study, Lima et al reported that during venipuncture, both nutritive and nonnutritive sucking provided lower pain response compared to the control group receiving no analgesic stimulus (P0.05) suggesting adequate analgesic relief in the control group. Lastly, Liaw et al, demonstrated that non-nutritive sucking during heel-stick procedures had the lowest mean PIPP scores (6.39) as compared to facilitated tucking (7.15) and the control (9.52), which received only routine care. Additionally, odds ratios for pain and severe pain in the NNS vs. control groups were 0.39 and 0.23 respectively, indicating the NNS group had a reduced change of experiencing pain.

CONCLUSIONS: All three RCT’s reported reduced incidence and severity of pain in these infants, thus suggesting that non-nutritive sucking does provide adequate analgesia during procedures that typically induce painful stimulation.