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OBJECTIVE:Ophthalmologic examination for retinopathy of prematurity is a painful procedure. Pharmacological and non-pharmacological interventions have been proposed to reduce pain during eye examinations. This study aims to evaluate the analgesic effect of 25% glucose using a validated pain scale during the first eye examination for retinopathy of prematurity in preterm infants with birth weight ≤1,500 g and/or gestational age ≤32 weeks.METHODS:A masked, randomized clinical trial for one dose of 1 ml of oral 25% glucose solution 2 minutes before the first ophthalmologic examination for retinopathy of prematurity was conducted between March 2008 and April 2010. The results were compared to those of a control group that did not receive oral glucose solution. Pain was evaluated using a Neonatal Infant Pain Scale immediately before and immediately after the ophthalmologic examination in both groups. Clinicaltrials.gov: NCT00648687RESULTS:One hundred and twenty-four patients who were examined for the first time for retinopathy of prematurity were included. Seventy were included in the intervention group and 54 in the control group. The number of patients with pain immediately before the procedure was similar in both groups. The number of patients with pain after ophthalmologic examination was 15.7% in the intervention group and 68.5% in the control group (p<0.001).CONCLUSIONS:One ml of oral 25% glucose solution given 2 minutes before an ophthalmologic examination for retinopathy of prematurity was an effective measure for pain relief.

BackgroundImproved survival of preterm neonates has increased the incidence of retinopathy of prematurity (ROP) in many middle-income countries.AimThis study aimed to verify the main risk factors for the development of ROP according to different gestational age (GA) groups.MethodsA prospective cohort study including infants weighing ≤1,500 g or GA ≤32 weeks at birth was conducted. The main clinical outcomes were the occurrence of any stage of ROP and severe ROP. The perinatal variables considered for the study were: birth weight; GA; gender; to be small for GA (SGA); weight gain from birth to the sixth week of life; use of oxygen in mechanical ventilation or nasal CPAP; multiple gestations; therapeutic use of surfactant, indomethacin, and erythropoietin; occurrence of sepsis, meningitis, intraventricular hemorrhage, and patent ductus arteriosus; need for and volume of blood transfusion; and 10-min Apgar score. The patients were divided into three groups according to GA: (group 1) infants of GA ≤28 weeks at birth (n = 100); (group 2) infants of GA = 29–31 weeks at birth (n = 215); and (group 3) infants of GA ≥32 weeks at birth (n = 152).ResultsA total of 467 newborn infants were included. Mean BW and GA in the total cohort were 1,216.5 g (±278.3) and 30.3 weeks (±2.2), respectively. Gestational age groups were not matched for BW and SGA. Any stage of ROP occurred in 111 patients (23.8%) and 24 (5.1%) patients developed severe ROP. Only BW and volume of blood transfusion were significant factors for the occurrence of any stage of ROP in all groups. In group 1, GA, the twin situation, and use of erythropoietin were statistically significant factors. In group 2, only GA and need for blood transfusion were significant. In group 3, use of oxygen in mechanical ventilation, sepsis, and need for blood transfusion were significant for ROP onset. The logistic regression determined that patients in groups 2 and 3 were less likely to develop ROP than patients in group 1.ConclusionsPatients in groups 1 and 2 developed ROP due to general immaturity, whereas bigger babies, of GA ≥32 weeks, developed ROP because they were “sicker” babies with more comorbidities.