Efficacy of 25% Glucose in Pain Alleviation During Retinopathy of Prematurity (ROP) Screening: A Randomized Controlled Trial

Abstract-Retinopathy of prematurity (ROP) remains a painful examination, despite the common application of local anesthetic eye drops. This study aimed at examining the analgesic effects of 25% glucose in a premature infant pain profile (PIPP) in the first eye examination of infants with ROP.This three-group, randomized clinical trial was conducted from March to February 2017. One oral dose of 25% glucose solution (1 cc/kg) was administered one minute before the first examination of ROP. Mydriatic and anesthetic eye drops were locally instilled in the eyes before examination for each group. Then, comparisons were made with the control group, which did not receive oral glucose (B), as well as the group which received 1 cc/kg of distilled water (C). The main investigator, who was blinded to the groups, evaluated pain using PIPP at one minute before, during, and one and five minutes after the procedure (ethics code: IR.TUMS.MEDICINE.REC.1396.3130). The baseline characteristics were comparable between the groups. During the procedure, the group receiving oral 20% glucose showed significantly lower PIPP scores (13.8±1.39), compared to the other groups (group B: 15.95±1.27 and group C: 15.10±1.19) (P= 0.001). The positive effects persisted for five minutes in this group after the procedure (7.6±1.26), compared to the other groups (P= 0.034). During and after ROP screening, oral 25% glucose in combination with local anesthetic eye drops can cause a significant reduction in pain.