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Topical anesthesia during infant eye examinations: does it reduce stress?
R A Saunders1, K W Miller, H H Hunt
1Department of Ophthalmology, Medical University of South Carolina, Charleston.
Insights
Topical anesthetic eye drops, like proparacaine HCl, did not reduce infant stress or corneal haze during retinopathy of prematurity examinations. Normal saline was equally effective for premature infants undergoing routine eye exams.
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.
Abstract:
We studied the effect of topical anesthesia on infant stress and corneal haze during the routine eye examination for retinopathy of prematurity. Using a double-blind protocol, 55 premature infants weighing less than 1501 g at birth were selected randomly to receive normal saline or proparacaine HCl 0.5% eye drops as a corneal wetting agent at their initial eye examination. Before, during, and after the procedure, infant stress was evaluated by heart rate, respiration rate, blood pressure, and transcutaneous oxygen saturation. Subjective assessment of the infant's cry intensity and corneal haze also were recorded. Adequate data were collected on 42 patients. Using analysis of variance and chi-square tests, we found no difference in any of these parameters between the two patients groups. These data suggest that topical anesthetic agents offer no advantage over normal saline eye drops during the examination of premature infants.