Archives of disease in childhood. Fetal and neonatal edition · 2011
Nitrous oxide analgesia during retinopathy screening: a randomised controlled trial.
СтатьяРандомизированное исследованиеПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод пока не подготовлен
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Mandel Romain, Ali Nabeel, Chen John, Galic Ivan John, Levesque Linda
Аннотация
OBJECTIVES: To determine if the addition of an inhaled equimolar mixture of nitrous oxide (N(2)O) and oxygen (EMONO) would produce superior pain relief to standard pharmacological and non-pharmacological measures during eye examination screening for retinopathy of prematurity (ROP) in premature infants.
STUDY DESIGN: A randomised, double-blind controlled trial was conducted. Setting Royal Victoria Hospital, a tertiary neonatal intensive care unit in Montreal, Canada.
PATIENTS: Stable spontaneously breathing premature infants with birth weights less than 1500 g or gestation of 30 weeks and less.
INTERVENTION: During the eye examination, all infants were swaddled, received oral sucrose and topical anaesthetics. Control group infants received a mixture of 50% oxygen and 50% nitrogen (n=18) administered by nasal cannula, while the intervention group received EMONO (50% oxygen and 50% N(2)O).
MAIN OUTCOME MEASURES: Pain was assessed by the premature infant pain profile (PIPP).
RESULTS: The mean PIPP score at speculum insertion in the control group (8.4, 95% CI 7.6 to 9.3) was comparable with the EMONO group (8.5, 95% CI 7.3 to 9.8) with a p value of 0.94. There were no significant differences in heart rate or saturation between the two groups. EMONO inhalation was tolerated without any measured side effects.
CONCLUSION: EMONO does not produce any additional pain relief over currently used measures during ROP screening eye examinations. Systematically combining pharmacological and non-pharmacological treatment modalities appears to be the best option until newer treatments are proven effective.
STUDY DESIGN: A randomised, double-blind controlled trial was conducted. Setting Royal Victoria Hospital, a tertiary neonatal intensive care unit in Montreal, Canada.
PATIENTS: Stable spontaneously breathing premature infants with birth weights less than 1500 g or gestation of 30 weeks and less.
INTERVENTION: During the eye examination, all infants were swaddled, received oral sucrose and topical anaesthetics. Control group infants received a mixture of 50% oxygen and 50% nitrogen (n=18) administered by nasal cannula, while the intervention group received EMONO (50% oxygen and 50% N(2)O).
MAIN OUTCOME MEASURES: Pain was assessed by the premature infant pain profile (PIPP).
RESULTS: The mean PIPP score at speculum insertion in the control group (8.4, 95% CI 7.6 to 9.3) was comparable with the EMONO group (8.5, 95% CI 7.3 to 9.8) with a p value of 0.94. There were no significant differences in heart rate or saturation between the two groups. EMONO inhalation was tolerated without any measured side effects.
CONCLUSION: EMONO does not produce any additional pain relief over currently used measures during ROP screening eye examinations. Systematically combining pharmacological and non-pharmacological treatment modalities appears to be the best option until newer treatments are proven effective.