title: Sweeten, soother and swaddle for retinopathy of prematurity screening: a randomised placebo controlled trial.
abstract: OBJECTIVE
  To assess the efficacy of oral sucrose combined with swaddling and non-nutritive suck (NNS) as a method for reducing pain associated with retinopathy of prematurity (ROP) screening.
  
  
  METHODS
  Randomised placebo controlled study.
  
  
  METHODS
  Tertiary level neonatal intensive care unit.
  
  
  METHODS
  40 infants undergoing primary eye examination for ROP screening.
  
  
  METHODS
  The control group were swaddled, and received 0.2 ml of sterile water given by mouth using a syringe and a soother. The intervention group were swaddled, and received 0.2 ml of sucrose 24% given by mouth using a syringe and a soother.
  
  
  RESULTS
  40 infants were included in the study. There was no difference in mean gestational age at birth, mean birth weight or corrected gestational age at first examination between both groups. The sucrose group had a significantly lower median Neonatal Pain, Agitation and Sedation Scale (N-PASS) score during ROP screening, initially following insertion of the speculum (6.5 vs 5, p=0.02) and subsequently during scleral indentation (9.5 vs 7.5, p=0.03). Fewer infants experienced episodes of desaturations or bradycardia in the intervention group (1 vs 4, p=0.18).
  
  
  CONCLUSIONS
  ROP screening is a necessary but recognised painful procedure. Sucrose combined with NNS and swaddling reduced the behavioural and physiological pain responses. However, pain scores remained consistently high and appropriate pain relief for ROP screening remains a challenge.
authors.affiliation: Department of Paediatrics and Newborn Medicine, Coombe Women and Infants University Hospital, Dublin, Ireland.
authors.forename: A
authors.initials: A
authors.lastname: O'Sullivan
authors.forename: M
authors.initials: M
authors.lastname: O'Connor
authors.forename: D
authors.initials: D
authors.lastname: Brosnahan
authors.forename: K
authors.initials: K
authors.lastname: McCreery
authors.forename: E M
authors.initials: EM
authors.lastname: Dempsey
mesh_terms: D000284:Administration, Oral; D000698:Analgesia / Q000379:methods*; D000700:Analgesics / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007224:Infant Care / Q000379:methods; D007231:Infant, Newborn; D007234:Infant, Premature; D015931:Intensive Care, Neonatal / Q000379:methods; D008297:Male; D015997:Neonatal Screening / Q000009:adverse effects* / Q000379:methods; D041361:Pacifiers; D010146:Pain / Q000209:etiology / Q000517:prevention & control*; D010147:Pain Measurement / Q000379:methods; D010808:Physical Examination / Q000009:adverse effects / Q000379:methods; D011446:Prospective Studies; D012178:Retinopathy of Prematurity / Q000175:diagnosis*; D013395:Sucrose / Q000008:administration & dosage
chemical_list: D000700:Analgesics; D013395:Sucrose