ANALGESIC EFFICACY OF EXPRESSED BREAST MILK, 10% DEXTROSE AND STERILE WATER IN PREVENTION OF PAIN DURING SCREENING OF RETINOPATHY OF PREMATURITY- A THREE LIMBED DOUBLE BLINDED RANDOMIZED CONTROL TRIAL

Abstract

Introduction : Retinopathy of prematurity is a potentially blinding eye disorder that primarily affects premature infants weighing about 1750 gm or less or born before 34 weeks of gestation. It occurs when abnormal blood vessel grows and spread throughout retina. Aim: To compare efcacy of analgesia during screening of Rtinopathy of Prematurity by EBM, 10% Dextrose and Sterile Water in preterm neonates as measured by prematurity infant pain prole (PIPP) score. Material and Methods: The present study was a three-limbed randomized controlled double-blinded study. This Study was conducted over 2 years at Dept. of Paediatrics (NICU) and RIO, IGIMS, Patna. A total of 75 patients were included in this study who were eligible for ROP screening as per NNF 2020 guidelines. Result: Data of our study showed that almost all patients had Oxygenation [74 (98.7%)] and Respiratory Distress [73 (97.3%)]. Apnea was observed to be absent in more than half of the cases [42 (56%)]. In this study ROP staging was applicable for 39 cases and out of them most common stage identied was ROP Stage 2; the distribution of pain palliative method was observed to be 10% Dextrose in 26 cases (34.7%), EBM in 24 cases (32%) and sterile water in 25 cases (33.3%). The distribution of PIPP score inference elucidated that a signicantly higher number of patients had moderate pain (6-12 score) [53 (70.7%)]. In our study, higher number of patients had moderate pain (6-12) as per PIPP Score with Expressed Breast Milk [21 (91.3%)] compared to Sterile Water [17 (59.3%)] and 10% Dextrose [16 (61.5%)] and this was statistically signicant (p=0.0444). In our study Total PIPP score was highest in Sterile Water [11.4615± 1.3633] compared to 10% Dextrose [9.4231± 2.5640] and Expressed Breast Milk [9.0000± 2.3741] and this nding was statistically signicant (p=0.0002). Conclusion: EBM was found to be signicantly better in pain palliation during ROP screening as compared to 10 % Dextrose and Sterile water