The aim of this study was to assess neonatal pain scores during laser treatment for retinopathy of prematurity (ROP) under sub-tenon anaesthetic with oral or rectal sedation. Sixty-two babies were included who have had ROP laser treatment over a seven year period. Pain scores were assessed using the Neonatal Pain Agitation and Sedation Scale (N-PASS) every 10 minutes during laser treatment. The outcome and requirement for re-treatment in this group was compared with that in the intravenous sedation group. Pain scores were available in 19 of the 27 babies treated under sub-tenon anaesthesia. The mean pain score during treatment was 2.7 (SD±1.7, range 0.5–6.2). There was no statistically significant correlation between the mean pain score and duration of treatment, number of laser burns, or post-menstrual age of the baby at the time of treatment. Both treatments were equally successful irrespective of the sedation method. The mean pain scores during laser treatment under sub-tenon anaesthesia were lower than those previously reported during ROP screening or heel-stick procedure. This study supports that sub-tenon anaesthesia with oral or rectal sedation provides sufficient pain control for laser treatment for ROP without the need or risks of intravenous sedation and intubation.

Pain score assessment in babies undergoing laser treatment for retinopathy of prematurity under sub-tenon anaesthesia.
Novitskaya ES, Kostakis V, Broster SC, et al.
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Nana Theodorou

BMedSCi (Hons) PhD, Sheffield Teaching Hospitals NHS Foundation Trust, Clinical Research Office, 11 Broomfield Road, Sheffield, S10 2SE, UK.

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