Pain management during eye examinations for retinopathy of prematurity in preterm infants: a systematic review.
OBJECTIVE
To assess whether non-pharmacological and/or pharmacological measures lead to decreased pain during an eye examination in preterm infants.


METHODS
.


METHODS
Systematic review.


METHODS
Premature infants meeting the criteria for screening eye examination for retinopathy.


METHODS
Databases were searched through the Ovid interface. Randomized and quasi-randomized controlled trials were included. Data were assessed independently by three reviewers.


METHODS
Pain assessed by Premature Infant Pain Profile (PIPP) or physiological changes.


RESULTS
Eight studies were included and grouped according to intervention: oral sucrose (group 1), anaesthetic eye drops (group 2) and non-pharmacological measures (group 3). For group 1, the mean PIPP score with sucrose was 1.38 (WMD) (95% CI: 0.41-2.35) lower than that of placebo (p = 0.005). For group 2, one study showed a reduction of two points on the PIPP score with topical proparacaine, whereas another showed no benefit. For group 3, developmental care improved developmental scores and salivary cortisol in one study.


CONCLUSIONS
Sucrose reduced pain during the eye examination, whereas the efficacy of proparacaine was not consistent in the studies included. However, PIPP scores remained relatively high in all the studies; thus further research is required to delineate better pain reduction strategies.
Sun
X
X
Department of Pediatrics, University of Ottawa, Ottawa, ON, Canada. blemyre@toh.on.ca
Lemyre
B
B
Barrowman
N
N
O'Connor
M
M
D000287:Administration, Topical; D000779:Anesthetics, Local / Q000008:administration & dosage*; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D010146:Pain / Q000209:etiology / Q000517:prevention & control*; D010147:Pain Measurement; D011430:Propoxycaine / Q000008:administration & dosage; D016032:Randomized Controlled Trials as Topic; D012178:Retinopathy of Prematurity / Q000175:diagnosis*; D013395:Sucrose / Q000008:administration & dosage*; D015351:Vision Screening / Q000009:adverse effects / Q000379:methods*
D000779:Anesthetics, Local; D013395:Sucrose; C005717:proxymetacaine; D011430:Propoxycaine