Efficacy of Oral Dextrose versus Acetaminophen versus Placebo on Pain Relief during Retinopathy of Prematurity Eye Examinations: A Randomized, Double-Blind Controlled Clinical Trial

Hamed Riyahi Madvar; Mahla Shadravan; Hamid Mousavi; Amir Khosrou Ghasemi Nejad; Anis Shamsi; Siva Sr Iyer; Ramak Roohipourmoallai

doi:10.4103/joco.joco_5_23

Efficacy of Oral Dextrose versus Acetaminophen versus Placebo on Pain Relief during Retinopathy of Prematurity Eye Examinations: A Randomized, Double-Blind Controlled Clinical Trial

J Curr Ophthalmol. 2024 Mar 29;35(3):276-280. doi: 10.4103/joco.joco_5_23. eCollection 2023 Jul-Sep.

Authors

Hamed Riyahi Madvar¹, Mahla Shadravan², Hamid Mousavi³, Amir Khosrou Ghasemi Nejad², Anis Shamsi², Siva Sr Iyer⁴, Ramak Roohipourmoallai⁵

Affiliations

¹ Clinical Research Development Department, Shafa Hospital, Kerman University of Medical Sciences, Kerman, Iran.
² Department of Ophthalmology, Kerman University of Medical Sciences, Kerman, Iran.
³ Department of Pediatrics, Kerman University of Medical Sciences, Kerman, Iran.
⁴ Department of Ophthalmology, University of Florida, Gainesville, FL, USA.
⁵ Department of Ophthalmology, Morsani College of Medicine, University of South Florida, Tampa, FL, USA.

Abstract

Purpose: To assess the effect of oral dextrose versus acetaminophen versus placebo in pain relief in retinopathy of prematurity (ROP) examination.

Methods: In this prospective randomized, double-blind controlled clinical trial study performed in the ophthalmology clinic of Shafa Hospital (referral hospital for eye disease), Kerman, Iran, 105 premature neonates with birth weight ≤2000 g and gestational age between 28 and 34 weeks were studied. Pain score measurement with Premature Infant Pain Profile-Revised (PIPP-R) during ROP examination in three intervention groups, acetaminophen group (15 mg/kg oral acetaminophen), dextrose group (one cc of oral dextrose 50%), and placebo group (one cc of distilled water), was done.

Results: Out of 105 infants, 33 infants received acetaminophen drops, 35 infants received dextrose drops, and 37 infants received placebo. The mean pain score of the group receiving acetaminophen was 11.39, dextrose 12.17, and placebo 11.54. The acetaminophen group had a lower average PIPP-R score. This difference was not significant between the three groups (P = 0.38).

Conclusions: Acetaminophen and dextrose in comparison with distilled water did not show a significant difference in reducing neonatal pain during ROP examinations. However, the PIPP-R score in the acetaminophen group was lower compared to the other groups.

Keywords: Acetaminophen; Dextrose; Infant; Retinopathy of prematurity.