Pain in neonates during screening for retinopathy of prematurity using binocular indirect ophthalmoscopy and wide-field digital retinal imaging: A randomised comparison

摘要

Objective: To compare the pain experienced by premature infants undergoing wide-field digital retinal imaging (WFDRI) and binocular indirect ophthalmoscopy (BIO) for retinopathy of prematurity (ROP) screening. Methods: Infants were recruited at Edinburgh Royal Infirmary Neonatal Unit, Edinburgh, UK. Eyes were examined by WFDRI and BIO with eyelid speculum by two experienced paediatric ophthalmologists in random order. A pain score (Premature Infant Pain Profile (PIPP)) for WFDRI and BIO was generated. Results: A total of 76 infants were recruited. The (mean, SD) PIPP score for WFDRI was 15.0, 2.1 and for BIO was 15.2, 2.4 (paired t test p=0.47). The authors observed that infants started crying with corresponding physiological changes as soon as the eyelid speculum was inserted and crying stopped on speculum removal. Conclusion: WFDRI and BIO with eyelid speculum are similarly painful for infants. The authors speculate that the eyelid speculum rather than the examination method may contribute most to the pain experienced.