J Pediatr Ophthalmol Strabismus. 2022 Nov-Dec;59(6):416-421. doi: 10.3928/01913913-20220225-01. Epub 2022 Apr 21.
To determine the safety and efficacy of ketamine analgesia as an alternative to general anesthesia during laser treatment for retinopathy of prematurity (ROP).
Eighteen premature neonates with ROP underwent laser treatment. The procedure was performed in the operating room, and the neonates were admitted to the neonatal intensive care unit (NICU) after the procedure. An initial dose of 1 mg/kg of ketamine was administered. If the neonate exhibited movement or distress during the procedure, incremental doses of ketamine were administered. Perioperative ventilation status, severity of pain during the procedure, surgeon satisfaction, and perioperative events were recorded.
Eighteen premature neonates underwent ketamine analgesia during laser treatment for ROP. The procedure was performed in 16 patients with good tolerance and without events. The Premature Infant Pain Profile (PIPP) scores during the procedure were 5 or less in 12 neonates (44.4%), 5 to 10 in 4 neonates (22.2%), and greater than 10 in 2 (11.1%) neonates. Three neonates had perioperative events, which resolved completely with minimal intervention. None of the neonates needed intubation perioperatively, and hemodynamic instability, hypotension, and bradycardia were not recorded in any of the neonates during or after the procedure.
The ROP laser treatment under ketamine sedation could be performed in premature neonates with few perioperative complications and provide satisfactory operative conditions. .
确定氯胺酮镇痛在早产儿视网膜病变（ROP）激光治疗中替代全身麻醉的安全性和有效性。
18 例 ROP 早产儿接受激光治疗。该手术在手术室进行，手术后患儿入住新生儿重症监护病房（NICU）。首先给予 1mg/kg 的氯胺酮初始剂量。如果患儿在手术过程中出现运动或不适，给予氯胺酮增量。记录围手术期通气状态、手术过程中疼痛的严重程度、外科医生满意度和围手术期事件。
18 例早产儿在 ROP 激光治疗中接受氯胺酮镇痛。16 例患儿手术耐受性良好，无事件发生。12 例患儿（44.4%）手术过程中的早产儿疼痛状况量表（PIPP）评分<5，4 例患儿（22.2%）评分 5-10，2 例患儿（11.1%）评分>10。3 例患儿围手术期出现事件，经最小干预后完全缓解。所有患儿均无需在围手术期插管，且术中及术后均未记录到患儿出现血流动力学不稳定、低血压和心动过缓。
氯胺酮镇静下的 ROP 激光治疗可在早产儿中进行，围手术期并发症少，可提供满意的手术条件。
