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.
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References
Quiroz-Mercado H, Ustariz-González O, Martinez-Castellanos MA, Covarrubias P, Dominguez F, Sanchez-Huerta V (2007) Our experience after 1765 intravitreal injections of bevacizumab: the importance of being part of a developing story. Semin Ophthalmol 22(2):109–125
Mintz-Hittner HA, Kennedy KA, Chuang AZ, BEAT-ROP Cooperative Group (2011) Efficacy of intravitreal bevacizumab for stage 3+ retinopathy of prematurity. N Engl J Med 364(7):603–615
Prenner J (2011) Anesthesia for Intravitreal injection. Retina 31(3):433–434
Blaha G, Tilton E, Barouch F, Marx J (2011) Randomized trial of anesthetic methods for intravitreal injections. Retina 31:535–539
Chen SD, Sundaram V, Wilkinson A, Patel CK (2007) Variation in anaesthesia for the laser treatment of retinopathy of prematurity—a survey of ophthalmologists in the UK. Eye 21(8):1033–1036
Stevens B, Johnson C, Taddio A (1996) Premature Infant Pain Profile: development and initial validation. Clin J Pain 12:13–22
McGee HT, Fraunfelder FW (2007) Toxicities of topical ophthalmic anesthetics. Expert Opin Drug Saf 6(6):637–640
Kandasamy Y, Smith R, Wright I, Hartley L (2011) Pain relief for premature infants during ophthalmology assessment. J AAPOS 15(3):276–280
Cogen M, Parker J, Sleep T, Elsas F, Metz T, McGwing G (2011) Masked trial of topical anesthesia for retinopathy of prematurity eye examinations. J AAPOS 15(1):45–48
Mehta M, Mansfield T, Vander Veen DK (2010) Effect of topical anesthesia and age on pain scores during retinopathy of prematurity screening. J Perinatol 30(11):731–735
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The authors have full control of all primary data, and they agree to allow Graefe's Archive for Clinical and Experimental Ophthalmology to review their data upon request.
Authors have no financial relationship with the manufacturer of any product discussed in this manuscript.
Clinical Trials Registration Number: NCT00346814
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Castellanos, M.A.M., Schwartz, S., Leal, R. et al. Pain assessment in premature infants treated with intravitreal antiangiogenic therapy for retinopathy of prematurity under topical anesthesia. Graefes Arch Clin Exp Ophthalmol 251, 491–494 (2013). https://doi.org/10.1007/s00417-012-2060-2
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DOI: https://doi.org/10.1007/s00417-012-2060-2