QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Résumé Extracto Full Text PDF For Our Patients Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Articles Ahead of Print [Order Reprint] Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Gal, P. Articles by Ransom, J L. Search for Related Content PubMed PubMed Citation Articles by Gal, P. Articles by Ransom, J L.

NEONATOLOGY

Efficacy of Sucrose to Reduce Pain in Premature Infants During Eye Examinations for Retinopathy of Prematurity

Director, Pharmacy Division, Greensboro Area Health Education Center, Greensboro, NC; Clinical Professor, School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC; Pharmacotherapy Specialist, Department of Neonatology, Women's Hospital, Greensboro

Grace E Kissling, PhD

Staff Scientist, Biostatistics Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC

William O Young, MD

Consulting Ophthalmologist, Neonatal Intensive Care Unit, Women's Hospital; Pediatric Ophthalmology Associates PA, Greensboro

Kimberly K Dunaway, PharmD

Staff Pharmacist, Pharmacy Department, Women's Hospital

Virginia A Marsh, RN BSN

Staff Nurse, Nursing Department, Neonatal Intensive Care Unit, Women's Hospital

Susan M Jones, RNC BSN

Staff Nurse, Nursing Department, Neonatal Intensive Care Unit, Women's Hospital

Dawn H Shockley, RN BS ADN

Staff Nurse, Nursing Department, Neonatal Intensive Care Unit, Women's Hospital

Nicole L Weaver, RN BSN

Staff Nurse, Nursing Department, Neonatal Intensive Care Unit, Women's Hospital

Rita Q Carlos, MD

Neonatologist, Neonatal Intensive Care Unit, Women's Hospital

J Laurence Ransom, MD

Medical Director, Neonatal Intensive Care Unit, Women's Hospital; Clinical Professor, Department of Pediatrics, School of Medicine, University of North Carolina at Chapel Hill

Reprints: Dr. Gal, Greensboro AHEC, Ste. 100, 200 E. Northwood St., Greensboro, NC 27401-1020, fax 336/832-7851, peter.gal{at}mosescone.com

BACKGROUND: Eye examinations for retinopathy of prematurity (ROP) are painful to the neonate. The use of topical anesthetic for eye examinations to evaluate ROP is routine in our neonatal intensive care unit (NICU), but does not completely suppress painful responses. Sweet solutions have been shown to reduce procedural pain in newborns.

OBJECTIVE: To examine whether the addition of sucrose 24% to topical anesthetic improves procedural pain control during the ROP eye examination.

METHODS: Neonates born at 30 weeks' gestation were included in this placebo-controlled, double-blind, crossover study. Patients were randomly assigned to receive treatment with either proparacaine HCl ophthalmic solution 0.5% plus 2 mL of sucrose 24% or proparacaine HCl ophthalmic solution 0.5% plus 2 mL of sterile water (placebo) prior to an eye examination. In a subsequent eye examination, each patient received the alternate treatment. Oral sucrose and sterile water were prepared in the pharmacy in identical syringes, and physicians, nurses, and pharmacists in the NICU were blinded to the treatment given. Pain was measured using the Premature Infant Pain Profile (PIPP) scoring system, which measures both physical and physiologic measures of pain, and the scores were simultaneously assessed by 2 study nurses. PIPP scores were recorded 1 and 5 minutes before and after the eye examination and during initial placement of the eye speculum. The same ophthalmologist performed all eye examinations. Several different definitions of a pain response were investigated.

RESULTS: Twenty-three infants were studied, with 12 receiving sucrose and 11 receiving placebo as the first treatment. For 3 of the 5 definitions of pain response, patients experienced significantly less pain at speculum insertion with sucrose than with placebo. After the ROP examination, pain responses were similar with either sucrose or placebo.

CONCLUSIONS: Oral sucrose may reduce the immediate pain response in premature infants undergoing eye examination for ROP.

Key Words: pain, retinopathy of prematurity, sucrose

Published Online, April 26, 2005. www.theannals.com, DOI 10.1345/aph.1E477

This article has been cited by other articles:

				J. C. I. Tsao, S. Evans, M. Meldrum, T. Altman, and L. K. Zeltzer A Review of CAM for Procedural Pain in Infancy: Part I. Sucrose and Non-nutritive Sucking Evid. Based Complement. Altern. Med., December 1, 2008; 5(4): 371 - 381. [Abstract] [Full Text] [PDF]

				E M Boyle, Y Freer, Z Khan-Orakzai, M Watkinson, E Wright, J R Ainsworth, and N McIntosh Sucrose and non-nutritive sucking for the relief of pain in screening for retinopathy of prematurity: a randomised controlled trial Arch. Dis. Child. Fetal Neonatal Ed., May 1, 2006; 91(3): F166 - F168. [Abstract] [Full Text] [PDF]