• X Sun, B Lemyre, N Barrowman, and M O'Connor.
• Department of Pediatrics, University of Ottawa, Ottawa, ON, Canada. blemyre@toh.on.ca
• Acta Paediatr. 2010 Mar 1; 99 (3): 329-34.

AimTo assess whether non-pharmacological and/or pharmacological measures lead to decreased pain during an eye examination in preterm infants.Methods.DesignSystematic review.SubjectsPremature infants meeting the criteria for screening eye examination for retinopathy.InterventionDatabases were searched through the Ovid interface. Randomized and quasi-randomized controlled trials were included. Data were assessed independently by three reviewers.Main Outcome MeasuresPain assessed by Premature Infant Pain Profile (PIPP) or physiological changes.ResultsEight studies were included and grouped according to intervention: oral sucrose (group 1), anaesthetic eye drops (group 2) and non-pharmacological measures (group 3). For group 1, the mean PIPP score with sucrose was 1.38 (WMD) (95% CI: 0.41-2.35) lower than that of placebo (p = 0.005). For group 2, one study showed a reduction of two points on the PIPP score with topical proparacaine, whereas another showed no benefit. For group 3, developmental care improved developmental scores and salivary cortisol in one study.ConclusionSucrose reduced pain during the eye examination, whereas the efficacy of proparacaine was not consistent in the studies included. However, PIPP scores remained relatively high in all the studies; thus further research is required to delineate better pain reduction strategies.

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