What Is Best Practice for Providing Pain Relief During Retinopathy of Prematurity Eye Examinations?

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Abstract

Background:

Retinopathy of prematurity screenings is considered a painful procedure. Yet, preterm infants 30 weeks of gestation or less or weighing 1500 g or less or between 1500 and 2000 g or greater than 30 weeks of gestation with an unstable course are required to have these examinations until their eyes reach maturity.

Purpose:

A systematic search of the literature was conducted to answer the question “For premature infants undergoing retinal eye examinations, what interventions are the most effective for pain reduction?”

Methods/Search Strategy:

CINAHL Plus and MEDLINE were searched using the key words: retinopathy of prematurity and pain. The search was limited to the last 10 years and experimental or quasi-experimental studies attempting to reduce pain during eye examinations.

Findings/Results:

The search criteria yielded 14 studies that addressed interventions to decrease pain during examinations. Three strategies were noted for pain relief including nonpharmacological interventions (n = 9), topical anesthetics (n = 3), and examination techniques (n = 2). The findings indicate that these 3 strategies provided varying results for pain relief but could be beneficial if provided in a consistent protocol.

Implications for Practice:

Consequently, policies for pain management during retinopathy of prematurity examinations need to be used consistently. It is important for clinicians to consider using a combination of strategies that maximize comfort and provide pain relief.

Implications for Research:

There remains a need to continue to examine pain-relieving techniques for retinopathy of prematurity examinations. Further investigation is needed to evaluate effective strategies that mitigate pain and the pathways causing pain. In addition, investigating the clinical feasibility of examinations without speculum use may be worthwhile.

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