Background:  Circumcision is one of the most commonly performed surgical procedures in the United States.  Neonatal pain is often not managed appropriately.  Oral sucrose has become an important non-pharmacologic intervention for neonatal pain.

Methods:  A retrospective chart review of a convenience sample of newborns who received circumcisions from March to November 2006.  The first group of neonates received only topical anesthesia.  The second group received topical anesthesia and 24% oral sucrose.  The pain scale (NIPS) score of each group was compared before, during and after the procedure.

Results:  The experimental (oral sucrose) group included 155 medical records and the comparison group included 150 medical records.  The groups did not differ by gestational age, birth weight, pre-, during or post-circumcision pain scores.  The oral sucrose did not have a significantly different effect on any pain scores.  A secondary finding was that during circumcision, pain scores did differ depending on topical anesthesia used.  Neonates (N=305) receiving EMLA cream had significantly less pain than neonates receiving topical lidocaine spray (p= .05).

Conclusions:  Oral sucrose did not make a difference in neonatal pain during circumcision.  A secondary recommendation is to examine the type of anesthesia provided for circumcisions.  Limitations:  The NIPS pain scale was a new tool implemented 4 weeks prior to the chart review.  The use of oral sucrose was a new standard of care introduced during the chart review.  Education began in December 2005 for both.  Two observers were not used during data collection, therefore inter-rater reliability was not known for the NIPS tool.