Oral Dextrose for Pain Management during Laser Treatment of Retinopathy of Prematurity under Topical Anesthesia

Objective To evaluate efficacy of oral dextrose, in addition to topical anesthesia in providing pain relief during laser ablation therapy of retinopathy of prematurity (ROP). Methods In this randomized controlled trial, neonates with type 1 ROP undergoing laser ablation of peripheral retina were randomized to receive or not to receive 2 ml of 25 % dextrose orally just before the laser therapy. In both the groups, topical anesthesia was provided by instilling paracaine eye drops twice at 10 min interval just before the laser treatment. Main outcome was Premature Infant Pain Profile (PIPP) recorded before and 30 s after starting the laser treatment. Results Birth weight, gestation, stage and extent of ROP and other baseline variables were comparable among neonates randomized to dextrose (n= 12) or control (n= 12) groups. Both groups required comparable number of laser spots. PIPP scores was comparable in neonates randomized to dextrose or control groups and indicated significant amount of pain felt during laser ablation despite local anesthesia with or without oral dextrose. Conclusions Single dose of oral dextrose did not significantly reduce pain during laser treatment in premature neonates. Further studies with multiple doses of dextrose and its combination with other non-pharmacological (e.g., behavioral, physical) interventions may be needed.