Kataria Manisha, Narang Subina, Chawla Deepak, Sood Sunandan, Gupta Parul Chawla
Department of Ophthalmology, Government Medical College and Hospital, Sector 32, Chandigarh, India.
Indian J Pediatr. 2015 Aug;82(8):694-7. doi: 10.1007/s12098-015-1718-2. Epub 2015 Feb 17.
To evaluate efficacy of oral dextrose, in addition to topical anesthesia in providing pain relief during laser ablation therapy of retinopathy of prematurity (ROP).
In this randomized controlled trial, neonates with type 1 ROP undergoing laser ablation of peripheral retina were randomized to receive or not to receive 2 ml of 25 % dextrose orally just before the laser therapy. In both the groups, topical anesthesia was provided by instilling paracaine eye drops twice at 10 min interval just before the laser treatment. Main outcome was Premature Infant Pain Profile (PIPP) recorded before and 30 s after starting the laser treatment.
Birth weight, gestation, stage and extent of ROP and other baseline variables were comparable among neonates randomized to dextrose (n = 12) or control (n = 12) groups. Both groups required comparable number of laser spots. PIPP scores was comparable in neonates randomized to dextrose or control groups and indicated significant amount of pain felt during laser ablation despite local anesthesia with or without oral dextrose.
Single dose of oral dextrose did not significantly reduce pain during laser treatment in premature neonates. Further studies with multiple doses of dextrose and its combination with other non-pharmacological (e.g., behavioral, physical) interventions may be needed.
评估在早产儿视网膜病变（ROP）激光消融治疗期间，口服葡萄糖联合局部麻醉在缓解疼痛方面的疗效。
在这项随机对照试验中，接受周边视网膜激光消融治疗的1型ROP新生儿被随机分为两组，一组在激光治疗前口服2毫升25%的葡萄糖，另一组不口服。两组均在激光治疗前每隔10分钟滴入两次丙美卡因滴眼液进行局部麻醉。主要观察指标是在开始激光治疗前和治疗开始后30秒记录的早产儿疼痛量表（PIPP）。
随机分为葡萄糖组（n = 12）或对照组（n = 12）的新生儿，其出生体重、孕周、ROP分期和范围以及其他基线变量具有可比性。两组所需的激光光斑数量相当。随机分为葡萄糖组或对照组的新生儿的PIPP评分相当，表明无论是否口服葡萄糖进行局部麻醉，在激光消融过程中均感觉到明显疼痛。
单剂量口服葡萄糖并不能显著减轻早产儿激光治疗期间的疼痛。可能需要进一步研究多剂量葡萄糖及其与其他非药物（如行为、物理）干预措施的联合应用。
