Department of Pediatrics, Division of Neonatology, McGill University Health Centre, Royal Victoria Hospital, 687 Pine Avenue West, Montreal, QC, Canada.
Arch Dis Child Fetal Neonatal Ed. 2012 Mar;97(2):F83-7. doi: 10.1136/adc.2011.210740. Epub 2011 Aug 10.
To determine if the addition of an inhaled equimolar mixture of nitrous oxide (N(2)O) and oxygen (EMONO) would produce superior pain relief to standard pharmacological and non-pharmacological measures during eye examination screening for retinopathy of prematurity (ROP) in premature infants.
A randomised, double-blind controlled trial was conducted. Setting Royal Victoria Hospital, a tertiary neonatal intensive care unit in Montreal, Canada.
Stable spontaneously breathing premature infants with birth weights less than 1500 g or gestation of 30 weeks and less.
During the eye examination, all infants were swaddled, received oral sucrose and topical anaesthetics. Control group infants received a mixture of 50% oxygen and 50% nitrogen (n=18) administered by nasal cannula, while the intervention group received EMONO (50% oxygen and 50% N(2)O).
Pain was assessed by the premature infant pain profile (PIPP).
The mean PIPP score at speculum insertion in the control group (8.4, 95% CI 7.6 to 9.3) was comparable with the EMONO group (8.5, 95% CI 7.3 to 9.8) with a p value of 0.94. There were no significant differences in heart rate or saturation between the two groups. EMONO inhalation was tolerated without any measured side effects.
EMONO does not produce any additional pain relief over currently used measures during ROP screening eye examinations. Systematically combining pharmacological and non-pharmacological treatment modalities appears to be the best option until newer treatments are proven effective.
确定在早产儿视网膜病变（ROP）筛查的眼部检查中，吸入等摩尔混合一氧化二氮（N2O）和氧气（EMONO）是否比标准药物和非药物治疗更能有效缓解疼痛。
这是一项随机、双盲对照试验。地点为加拿大蒙特利尔的一家三级新生儿重症监护病房——皇家维多利亚医院。
胎龄小于 30 周且出生体重小于 1500 克、自主呼吸稳定的早产儿。
所有婴儿在眼部检查时都被包裹好，接受口服蔗糖和局部麻醉。对照组婴儿通过鼻导管接受 50%氧气和 50%氮气（n=18）的混合气体，而干预组婴儿则接受 EMONO（50%氧气和 50%N2O）。
疼痛通过早产儿疼痛状况量表（PIPP）进行评估。
对照组在窥镜插入时的平均 PIPP 评分（8.4，95%CI 7.6 至 9.3）与 EMONO 组（8.5，95%CI 7.3 至 9.8）相似，p 值为 0.94。两组之间的心率或饱和度没有显著差异。EMONO 吸入耐受性良好，没有任何可测量的副作用。
在 ROP 筛查眼部检查中，EMONO 并没有比目前使用的措施带来额外的疼痛缓解效果。在新的治疗方法被证明有效之前，系统地结合药物和非药物治疗方法似乎是最佳选择。
