Multicenter observational study comparing sedation/analgesia protocols for laser photocoagulation treatment of retinopathy of prematurity

J Perinatol. 2015 Nov;35(11):965-9. doi: 10.1038/jp.2015.112. Epub 2015 Sep 10.

Abstract

Objective: The aim of this study was to identify the best sedation/analgesia protocol for laser photocoagulation (PC) of retinopathy of prematurity (ROP).

Study design: This multicenter observational study included five hospitals, each using a specific sedation/analgesia protocol: local anesthesia with oxybuprocaine hydrochloride (Group L); intravenous pentazocine (Group P); intravenous fentanyl (Group F); air, oxygen and sevoflurane (AOS) inhalation (Group I). The groups were compared for pain responses, vital signs and adverse events.

Results: Heart rates and systemic blood pressures were elevated by PC in Groups L and P and Groups L, P and F, respectively. Moreover, poor analgesic efficacy was recognized in Groups L, P and F. In contrast, Group I experienced hypothermia, enteral feeding intolerance and apnea more frequently.

Conclusion: From the viewpoint of sedation/pain relief, AOS anesthesia should be the best protocol. However, considering all the various factors together, the most reasonable one can be varied based on the patient's condition and hospital.

Publication types

  • Comparative Study
  • Multicenter Study
  • Observational Study

MeSH terms

  • Administration, Inhalation
  • Cohort Studies
  • Conscious Sedation / methods*
  • Female
  • Fentanyl / administration & dosage
  • Humans
  • Infant, Newborn
  • Infant, Premature*
  • Infusions, Intravenous
  • Japan
  • Laser Therapy / methods
  • Light Coagulation / methods*
  • Male
  • Methyl Ethers / administration & dosage
  • Pain Measurement*
  • Pentazocine / administration & dosage
  • Prospective Studies
  • Retinopathy of Prematurity / diagnosis
  • Retinopathy of Prematurity / surgery*
  • Risk Assessment
  • Severity of Illness Index
  • Sevoflurane
  • Treatment Outcome

Substances

  • Methyl Ethers
  • Sevoflurane
  • Pentazocine
  • Fentanyl