Comparing the Efficacy of Oral Sucrose and Acetaminophen in Pain Relief for Ophthalmologic Screening of Retinopathy of Prematurity

Abstract

Retinopathy of prematurity (ROP) is a potential cause for visual impairment in preterm newborn infants with gestation age 32 weeks or less and birth weight less than1500 gram. There are several studies that reported physiologic and behavioral responses to painful and stressing screening examination. This study was conducted to compare the efficacy of sucrose and acetaminophen in pain control during eye examination in premature infants. A prospective randomized clinical trial was carried out in a tertiary level NICU. One hundred twenty preterm infants were randomly allocated in to 3 groups. Group A received oral acetaminophen 15mg/kg 30 minutes before eye examination and 0.2ml sterile water, given by mouth using a syringe, during examination; group B 0.2ml sucrose 25% and group C 0.2ml sterile water given by mouth using a syringe during examination. Ophthalmologic examinations were recorded by videotape. Pain score was determined by using PIPP during first 45 seconds and at last 45 seconds of eye examination. There was no significant difference between groups regarding gestation age, birth weight and age at examination. The mean PIPP score at first 45 sec were 12.9±2.4, 9±2.1 and 13.7±1.6 for groups A, B, and C respectively (p<0.001). It was 12.3±2.4, 11.2±3 and 12.1±2.6 at last 45 sec of examination in groups A, B, and C respectively P=0.12.Two patients had apnea during first 12 hours after examination and both of them were in group C. In our study, using sucrose was associated with reduced pain score in neonates undergoing screening for ROP at beginning of eye examination but not at the last seconds of examination.