Background and aim Retinopathy of prematurity (ROP) is one of the major morbidity among preterm infants. Although, local anesthetics reduce pain to some extent, eye examination still remains as a painful procedure. We aimed to evaluate the effect of oral sucrose combined with local anesthetics for pain relief during ophthalmological examination.
Method A total of forty patients under 32 weeks of gestational age were included in the study. Infants were randomly assigned to receive either oral sucrose solution (Group-1; n=21) or sterile water (Group-2; n=19) combined with topical proparacaine hydrochloride two minutes before examination. Pacifier was used in all patients as non-nutritive sucking during the study. Pain score was evaluated by premature infant pain profile (PIPP) scale. Each infant was videorecorded during and after the procedure.
Results Both groups were similar in terms of gestational age, birth weight, postnatal age and actual weight. There was no significant difference between groups in behavioral state, heart rate and oxygen saturation before the examination. At speculum insertion, heart rate variability was similar in both groups whereas oxygen desaturation was apparent in Group-2 (Group-1: 1.7±0.8 and Group-2: 2.5±0.6, p=0.001) and PIPP scores were also lower in Group-1 (Group-1: 14.5±1.8 and Group-2: 17.2±1.7, p=0.001). Total time of crying was significantly shorter in Group-1 (Group-1: 58.8±12.1 and Group-2: 96.3±24, p=0.001).
Conclusion Procedural pain is known to have acute and even long term negative. behavioral and developmental effects in neonates. In our study, use of sucrose in addition to local anesthetics during ophthalmological examination is shown to attenuate pain.