Gal Peter, Kissling Grace E, Young William O, Dunaway Kimberly K, Marsh Virginia A, Jones Susan M, Shockley Dawn H, Weaver Nicole L, Carlos Rita Q, Ransom J Laurence
Pharmacy Division, Greensboro Area Health Education Center, Greensboro, NC 27401-1020, USA.
Ann Pharmacother. 2005 Jun;39(6):1029-33. doi: 10.1345/aph.1E477. Epub 2005 Apr 26.
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.
To examine whether the addition of sucrose 24% to topical anesthetic improves procedural pain control during the ROP eye examination.
Neonates born at < or = 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.
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.
Oral sucrose may reduce the immediate pain response in premature infants undergoing eye examination for ROP.
早产儿视网膜病变（ROP）的眼部检查对新生儿来说是痛苦的。在我们的新生儿重症监护病房（NICU），使用局部麻醉剂进行眼部检查以评估ROP是常规操作，但并不能完全抑制疼痛反应。已证明甜味溶液可减轻新生儿的操作疼痛。
研究在局部麻醉剂中添加24%的蔗糖是否能改善ROP眼部检查期间的操作疼痛控制。
本安慰剂对照、双盲、交叉研究纳入了孕周小于或等于30周的新生儿。在眼部检查前，患者被随机分配接受0.5%丙美卡因盐酸盐滴眼液加2 mL 24%蔗糖或0.5%丙美卡因盐酸盐滴眼液加2 mL无菌水（安慰剂）治疗。在随后的眼部检查中，每位患者接受替代治疗。口服蔗糖和无菌水在药房用相同的注射器配制，NICU的医生、护士和药剂师对所给予的治疗不知情。使用早产儿疼痛量表（PIPP）评分系统测量疼痛，该系统测量疼痛的身体和生理指标，分数由2名研究护士同时评估。在眼部检查前1分钟和5分钟、检查后以及初次放置开睑器时记录PIPP评分。所有眼部检查均由同一位眼科医生进行。研究了几种不同的疼痛反应定义。
研究了23名婴儿，其中12名首次接受蔗糖治疗，11名接受安慰剂治疗。对于5种疼痛反应定义中的3种，使用蔗糖时患者在插入开睑器时的疼痛明显低于使用安慰剂时。ROP检查后，使用蔗糖或安慰剂时的疼痛反应相似。
口服蔗糖可能减轻接受ROP眼部检查的早产儿的即时疼痛反应。
