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Nitrous oxide analgesia during retinopathy screening: a randomised controlled trial
Romain Mandel1, Nabeel Ali, John Chen
1Department of Pediatrics, Division of Neonatology, McGill University Health Centre, Royal Victoria Hospital, 687 Pine Avenue West, Montreal, QC, Canada.
Archives of Disease in Childhood. Fetal and Neonatal Edition
|August 13, 2011
Summary
Adding inhaled nitrous oxide and oxygen (EMONO) did not improve pain relief for premature infants during retinopathy of prematurity (ROP) eye exams. Current combined pain management strategies remain the most effective approach.
Area of Science:
- Neonatal Medicine
- Pediatric Anesthesiology
- Ophthalmology
Background:
- Retinopathy of prematurity (ROP) screening requires painful procedures for premature infants.
- Effective pain management is crucial during neonatal intensive care.
Purpose of the Study:
- To evaluate if inhaled equimolar mixture of nitrous oxide and oxygen (EMONO) offers superior pain relief compared to standard care during ROP screening.
- To assess the efficacy of EMONO in reducing pain in premature infants undergoing eye examinations.
Main Methods:
- A randomized, double-blind controlled trial was conducted in a tertiary neonatal intensive care unit.
- Premature infants (<1500g or ≤30 weeks gestation) received standard care (swaddling, sucrose, topical anesthetics) plus either nitrogen-oxygen or EMONO via nasal cannula.
- Pain was assessed using the Premature Infant Pain Profile (PIPP).
Main Results:
- The mean PIPP scores were comparable between the EMONO group (8.5) and the control group (8.4) at speculum insertion (p=0.94).
- No significant differences in heart rate or oxygen saturation were observed between groups.
- EMONO inhalation was well-tolerated with no reported side effects.
Conclusions:
- EMONO does not provide additional pain relief beyond standard measures for ROP screening eye examinations.
- Combining pharmacological and non-pharmacological pain management strategies is recommended for ROP screening procedures.
