Pain assessment in premature infants treated with intravitreal antiangiogenic therapy for retinopathy of prematurity under topical anesthesia

  • Maria Ana Martínez Castellanos
  • Shulamit Schwartz
  • Ricardo Leal
  • Robison Vernon Paul Chan
  • Hugo Quiroz-Mercado
Retinal Disorders

DOI: 10.1007/s00417-012-2060-2

Cite this article as:
Castellanos, M.A.M., Schwartz, S., Leal, R. et al. Graefes Arch Clin Exp Ophthalmol (2013) 251: 491. doi:10.1007/s00417-012-2060-2

Abstract

Purpose

To evaluate the physiological and behavioral pain response in premature infants receiving intravitreal bevacizumab injection (IVB) for retinopathy of prematurity (ROP) under topical anesthesia.

Methods

A prospective interventional non-comparative case series. Premature infants with high-risk prethreshold or threshold ROP received IVB using topical anesthesia with tetracaine eye drops. A Premature Infant Pain Profile was used to assess the pain response during the procedure.

Results

Nine premature infants requiring bilateral IVB therapy were included in the study. Mean gestational age was 28.7 ± 1.3 weeks, and birth weight was 1,200 ±194 grams. The mean total pain score was found to be 8.7 ± 2.4 (range 5–14), indicating generally mild pain during the procedure. Eye squeeze was the most prominent indicator of pain. Most changes occurred at the beginning, with the insertion of the lid speculum and were hardly noted during the rest of the procedure including the injection itself.

Conclusion

Topical anesthesia with tetracaine is an effective method for the relief of pain associated with intravitreal injections in premature infants with ROP.

Keywords

Retinopathy of prematurity Intravitreal injections Bevacizumab Local anesthesia 

Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • Maria Ana Martínez Castellanos
    • 1
    • 2
  • Shulamit Schwartz
    • 3
  • Ricardo Leal
    • 1
  • Robison Vernon Paul Chan
    • 4
  • Hugo Quiroz-Mercado
    • 3
  1. 1.Retina Service Asociación para Evitar la Ceguera en MéxicoHospital “Luis Sanchez Bulnes” I.A.PMexico CityMexico
  2. 2.Early Detection of Retinopathy of Prematurity ProgramHospital de Especialidades “Belisario Dominguez” Gobierno del Distrito FederalMexico CityMexico
  3. 3.Ophthalmology DepartmentDenver Health Medical Center, University of Colorado DenverDenverUSA
  4. 4.New York-Presbyterian HospitalWill Cornell Medical CollegeNew YorkUSA

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