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The pain response to mydriatic eyedrops in preterm infants

Journal of Perinatology volume 33, pages 462–465 (2013)Cite this article

Subjects

Abstract

Objective:

Evaluate physiological and behavioral pain responses of premature infants following instillation of mydriatic eyedrops for retinopathy of prematurity (ROP) examinations. While burning and stinging occurs in older patients, the infant pain response is not well characterized.

Study Design:

Vital sign and video monitor recorded infant responses before, during and after mydriatic (tropicamide 1%, phenylephrine 2.5%) administration upon first ROP exam. Two masked observers graded Premature Infant Pain Profile (PIPP) scores immediately before and following eyedrop administration. Scores <7 indicate no/minimal pain, 7 to 12 slight/moderate, >12 severe.

Result:

Twenty infants had mean premydriatic PIPP score 3.6 (s.d. 1.6), mean postmydriatic score 5.7 (s.d. 3.4), mean change 2.1 (s.d. 3.4) (P=0.01). One (5%) had premydriatic PIPP score ⩾7, seven (35%) post scores ⩾7 (P=0.07) with one >12.

Conclusion:

Mydriatic drops cause a clinically significant pain response in one-third of infants. Non-pharmacological supportive measures are recommended for all infants until predictive factors are defined.

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Acknowledgements

This work was supported by NIH K12-EY015398, NIH P30 EY01583-26 and the NIH Loan Repayment Program.

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The sponsor had no role in the study design; collection, analysis and interpretation of data; writing of the report; or decision to submit the manuscript for publication.

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Authors and Affiliations

  1. Divisions of Neonatology, The Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    A M Cohen, N Cook & M C Harris

  2. Departments of Pediatrics, The Pereleman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA

    A M Cohen, N Cook & M C Harris

  3. Department of Ophthalmology, The Pereleman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA

    G-S Ying & G Binenbaum

  4. Department of Ophthalmology, The Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    G Binenbaum

Authors
  1. A M Cohen
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  2. N Cook
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  3. M C Harris
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Correspondence to G Binenbaum.

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Cohen, A., Cook, N., Harris, M. et al. The pain response to mydriatic eyedrops in preterm infants. J Perinatol 33, 462–465 (2013). https://doi.org/10.1038/jp.2012.149

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  • DOI: https://doi.org/10.1038/jp.2012.149

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