Topical anesthesia during infant eye examinations: does it reduce stress?

Area of Science:

• Ophthalmology
• Neonatology
• Pediatric Anesthesiology

Background:

• Routine eye examinations for retinopathy of prematurity (ROP) are crucial for premature infants.
• Assessing infant stress and corneal effects during these procedures is important for patient comfort and data accuracy.

Purpose of the Study:

• To evaluate the efficacy of topical anesthetic eye drops (proparacaine HCl 0.5%) compared to normal saline in mitigating infant stress and corneal haze during ROP examinations.
• To determine if anesthetic agents offer an advantage over standard wetting agents in this vulnerable population.

Main Methods:

• A double-blind, randomized study involving 55 premature infants (<1501 g birth weight) undergoing their initial ROP eye examination.
• Infants received either proparacaine HCl 0.5% or normal saline eye drops.
• Infant stress was monitored via heart rate, respiration rate, blood pressure, and oxygen saturation. Corneal haze and cry intensity were also assessed.

Main Results:

• Adequate data were collected from 42 infants.
• No statistically significant differences were observed in heart rate, respiration rate, blood pressure, oxygen saturation, cry intensity, or corneal haze between the proparacaine HCl and normal saline groups.
• Analysis of variance and chi-square tests confirmed the lack of difference.

Conclusions:

• Topical anesthetic agents, specifically proparacaine HCl 0.5%, do not provide a demonstrable advantage over normal saline eye drops for reducing infant stress or corneal haze during ROP examinations.
• Normal saline appears to be a sufficient and effective corneal wetting agent for these routine procedures in premature infants.