Oral glucose for pain relief during examination for retinopathy of prematurity: a masked randomized clinical trial

Abstract

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.

Prevention and Management of Procedural Pain in the Neonate: An Update

“…For example, an RCT found no effect of glucose on pain response during ophthalmologic examinations. 86 …”

Efficacy of Single Dose Oral Paracetamol in Reducing Pain During Examination for Retinopathy of Prematurity: A Blinded Randomized Controlled Trial

“…A total of 9 (7.8 %) infants experienced episodes of desaturations and bradycardia without a significant difference between the groups. Oral paracetamol group had a significantly lower PIPP score during examination of the first eye, following insertion of the speculum [12 (9)(10)(11)(12)(13) vs. 14 (13-15), p 0.01] ( Table 2; Fig. 2).…”

“…Despite topical anesthetics and/or oral administration of non-pharmacological solutions such as oral sucrose, oral glucose or maternal milk before eye examination, most infants score highly on validated pain scores, such as the Premature Infant Pain Profile (PIPP) [11][12][13][14].…”

Does Oral 25% Dextrose Effectively Reduce Procedural Pain in Neonates – A Randomized Controlled Trial

“…The score was 2.6±1.1 in glucose group and 4.5±1.3 in control group indicating that 25% glucose was effective for pain relief. (12) In a study by Fusun Okan et al, pain relieving effect of glucose was compared to placebo after heel lancing. Pain response was assessed with Neonatal Facial Coding System (NFCS).…”

“…(8,9) Oral sweet solutions like sucrose and dextrose have been found to have pain relieving effects. (9,10) Trials using 25% dextrose (6,10,11,12) to reduce procedural pain in neonates have been done. Thus the following trial was done with the objective of determining the efficacy of oral 25% dextrose in comparison with placebo in reducing neonatal pain response after venepuncture with the help of PIPP pain scale.…”