Anesthetic Concerns in Patients with Retinopathy of Prematurity

Abstract

Retinopathy of prematurity (ROP) is a disorder of the developing retina of low birth weight preterm infants, that may be the potential cause of blindness in such infants. Peripheral retinal ablation with diode laser is the preferred method for treatment of severe ROP. Examination and surgery (laser ablation and cryotherapy) for ROP are known to be extremely stressful and probably painful to the neonate. Topical anesthetic pretreatment can reduce the pain response but is not effective in all neonates. Thus, even for simple examination of the eye, topical anesthetic alone may be insufficient. If we accept that laser therapy is at least stressful, if not significantly painful, it can be seen that these babies require more than minimal sedation. The case reports mentioned below describe two different ways of the anesthetic management of infants with ROP. The article focuses on the various anesthetic methods available, and anesthetic concerns in such infants.