The possible effect of light exposure reduction via eye patches after the examination for retinopathy in premature infants? An observational study in preterm neonates

Yıl 2023, Cilt: 9 Sayı: 5 - September 2023, 977 - 983, 04.09.2023

Gaffari Tunç , Duygu Yalınbaş Yeter , Feyzanur Karagöz , Emine Erva Tecer , Senem Akkan , Fatih Kılıçbay

https://doi.org/10.18621/eurj.1273038

Öz

Objectives: This study aimed to examine whether infants with and without eye patches differ in terms of vital signs and clinical status after retinopathy of prematurity examination.

Methods: Premature infants hospitalized in study center between June 2021-April 2022 were included. Group 1 is consisted of infants whose eyes were not closed after retinopathy of prematurity examination. Those infants whose eyes were closed eye-patches consisted of group 2. Vital signs were followed for 24 hours following the examination. Demographic, medical and follow-up data were all recorded prospectively. Vital signs were evaluated in accordance with birth week and weight. Pain score was evaluated by Neonatal Pain, Agitation, and Sedation Scale.

Results: Pain scores were found to be lower in group 2 (p < 0.020). Although the systolic blood pressure, diastolic blood pressure, and mean blood pressure values of group 2 were found to be lower than group 1, they were within normal limits (all p < 0.05). Vomiting was not observed at all in Group 1 (p = 0.036). There was no significant difference between the groups in terms of fever, respiratory rate, heart rate, SpO2, and blood glucose values.

Conclusions: This study showed that using an eye patch in infants after an eye examination reduces pain and increases comfort of infants. Although their pain scores are lower, taking necessary precautions are recommended for these patients in terms of vomiting. Thus, eye patches can be suggested as a non-pharmacological pain-reducing method after get advanced stagnation by the support of more studies with a larger number of participants.

Anahtar Kelimeler

Newborn, eye patch, light exposure, retinopathy of prematurity, non-pharmacological method

Teşekkür

We would like to thank the staff of Sivas Cumhuriyet University neonatal unit for their help.

Kaynakça

• 1. Szigiato AA, Speckert M, Zielonka J, Hollamby K, Altomare F, Ng E, et al. Effect of eye masks on neonatal stress following dilated retinal examination: The MASK-ROP randomized clinical trial. JAMA Ophthalmol 2019;137:1265-72.
• 2. Uslu S, Bülbül A. [Retinopathy of prematurity via neonatology perspective]. Şişli Etfal Hastanesi Tıp Bülteni 2011;45:142-52. [Article in Turkish]
• 3. Koç E, Yağmur Baş A, Özdek Ş, Ovalı F, Başmak H. Turkish Neonatal and Turkish Ophthalmology Societies consensus guideline on the retinopathy of prematurity. Turk Pediatr Ars 2018;53:151-60.
• 4. Bas AY, Koc E, Dilmen U, ROP neonatal Study Group. Incidence and severity of retinopathy of prematurity in Turkey. Br J Ophthalmol 2015;99:1311-4.
• 5. Löfqvist C, Andersson E, Sigurdsson J, Engström E, Hård AL, Niklasson A, et al. Longitudinal postnatal weight and insulin-like growth factor I measurements in the prediction of retinopathy of prematurity. Arch Ophthalmol 2006;124:1711-8.
• 6. Hellström A, Carlsson B, Niklasson A, Segnestam K, Boguszewski M, de Lacerda L, et al. IGF-I is critical for normal vascularization of the human retina. J Clin Endocrinol Metab 2002;87:3413-6.
• 7. Early Treatment For Retinopathy Of Prematurity Cooperative Group. Revised indications for the treatment of retinopathy of prematurity: results of the early treatment for retinopathy of prematurity randomized trial. Arch Ophthalmol 2003;121:1684-94.
• 8. Fierson WM; American Academy of Pediatrics Section on Ophthalmology; American Academy of Ophthalmology; American Association for Pediatric Ophthalmology and Strabismus; American Association of Certified Orthoptists. Screening examination of premature infants for retinopathy of prematurity. Pediatrics 2013;131:189-95.
• 9. Fierson WM; American Academy of Pediatrics Section on Ophthalmology; American Academy of Ophthalmology; American Association for Pediatric Ophthalmology and Strabismus; American Association of Certified Orthoptists. Screening examination of premature infants for retinopathy of prematurity. Pediatrics 2018;142:e20183061.
• 10. Mitchell AJ, Green A, Jeffs DA, Roberson PK. Physiologic effects of retinopathy of prematurity screening examinations. Adv Neonatal Care 2011;11:291-7.
• 11. Dilli D, Soylu H, Tekin N. Neonatal hemodynamics and management of hypotension in newborns. Turk Pediatri Ars 2018;53(Suppl 1):65-75.
• 12. Benbrook K, Manworren RCB, Zuravel R, Entler A, Riendeau K, Myler C, et al. Agreement of the neonatal pain, agitation, and sedation scale (N-PASS) with NICU nurses' assessments. Adv Neonatal Care 2023;23:173-81.
• 13. Marlier L, Gaugler C, Astruc D, Messer J. [The olfactory sensitivity of the premature newborn]. Arch Pediatr 2007;14:45-53. [Article in French]
• 14. Belda S, Pallás CR, De la Cruz J, Tejada P. Screening for retinopathy of prematurity: is it painful? Biol Neonate 2004;86:195-200.
• 15. Espino-torres E, Malloy M, Geary C. Eye patches reduce the pain and distress in infants undergoing pupillary dilation for the screening of retinopathy of prematurity. Poster presented at: 2012 Texas Pediatric Society Electronic Poster Contest 2012.
• 16. Johnston CC, Fernandes AM, Campbell-Yeo M. Pain in neonates is different. Pain 2011;152(3 Suppl):65-73.
• 17. Moral-Pumarega MT, Caserío-Carbonero S, De-La-Cruz-Bértolo J, Tejada-Palacios P, Lora-Pablos D, Pallás-Alonso CR. Pain and stress assessment after retinopathy of prematurity screening examination: indirect ophthalmoscopy versus digital retinal imaging. BMC Pediatr 2012;12:132.
• 18. Yiğit Ş, Ecevit A, Köroğlu ÖA. Turkish Neonatal Society guideline on the neonatal pain and its management. Turk Pediatri Ars 2018;53(Suppl 1):161-71.