ArticleBMJ open2017
Anaesthesia modalities during laser photocoagulation for retinopathy of prematurity: a retrospective, longitudinal study.
Article in BMJ open, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 2 of them syntheses that pooled it.
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Who cites it
16 citing papers in PubMed, 2 syntheses or guidelines pooled it, 32 citations in OpenAlex.
- Safety profile of anesthetic modalities during laser treatment for retinopathy of prematurity: a systematic review.Journal of perinatology : official journal of the California Perinatal Association · 2023Pooled it
- Neonatal Pain, Agitation, and Sedation Scale's use, reliability, and validity: a systematic review.Journal of perinatology : official journal of the California Perinatal Association · 2020Pooled it
- Trial
- Systemic outcomes of anesthesia method in anti-vascular endothelial growth factor therapy for retinopathy of prematurity: GeneralWorld journal of clinical pediatrics · 2026Article
- Comparison of Ventilation Support During Laser Treatment of Retinopathy of Prematurity.Children (Basel, Switzerland) · 2026Article
- Respiratory outcomes in preterm infants following intravitreal bevacizumab for retinopathy of prematurity-a 10-year matched case study.Eye (London, England) · 2023Article
- Twelve-year outcomes of bedside laser photocoagulation for severe retinopathy of prematurity.Frontiers in pediatrics · 2023Article
- Compared Methods for Reducing Stress in ROP Exams; Stake-Holding Examiner Perspective.Clinical ophthalmology (Auckland, N.Z.) · 2023Article
- Ten-year outcomes after initial management with laser photocoagulation versus intravitreal bevacizumab injection in a pair of identical twins with aggressive posterior retinopathy of prematurity.American journal of ophthalmology case reports · 2021Article
- Aerosol containment box for laser treatment of retinopathy of prematurity in COVID-19 pandemic.Indian journal of ophthalmology · 2021Article
- Retinopathy of prematurity treatment in the UK: trends in neonatal anaesthetic support and location of treatment from a national surveillance study.European journal of pediatrics · 2020Article
- Retinopathy of prematurity treatment: Asian perspectives.Eye (London, England) · 2020Review
- Anesthesia in retinopathy of prematurity.Saudi journal of ophthalmology : official journal of the Saudi Ophthalmological SocietyArticle
- Assessment of Outcomes With a Sedation Protocol During Laser Photocoagulation in Preterm Infants With Retinopathy of Prematurity.The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAGArticle
- Role of deferred retinal laser following intravitreal injection of bevacizumab in treatment of severe retinopathy of prematurity.Oman journal of ophthalmologyArticle
- Reducing Intubations and Related Risks in Neonates with Retinopathy of Prematurity Undergoing Laser Photocoagulation.Pediatric quality & safetyArticle
Corrections and comments
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Authors and funding
7 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesLaser photocoagulation surgery is a routine treatment for threshold retinopathy of prematurity (ROP). However, little is known about which anaesthesia protocols provide efficient pain control while minimising exposure risk to vulnerable infants. In this study, therefore, we assessed the efficacy and tolerability of multiple anaesthesia techniques used on premature infants during laser therapy. DESIGN AND
main outcome measuresAnaesthesia modalities consisted of topical eye drops anaesthesia, general anaesthesia and intravenous fentanyl sedation with mechanical ventilation. Laser treatment efficacy and detailed operative information were retrospectively and consecutively analysed. Cardiorespiratory stability was assessed and compared. The Neonatal Pain Agitation and Sedation Scale (N-PASS) was used to evaluate tolerability in infants that underwent intravenous fentanyl sedation.
results97 cases of prematurity were included in this study. In 94/97 (96.9%) cases, vascular proliferation regressed. In the topical anaesthesia groups, the ophthalmologist needed 12-16 min more to complete the treatment. During the 3 postoperative days, topical anaesthesia demonstrated the greatest instability; 4/31 (12.90%) infants in this group suffered from life threatening events requiring resuscitation. The only instability observed in general anaesthesia and fentanyl sedation was attributed to difficulty in extubating within 24 hours after surgery. During laser therapy, the N-PASS score increased to 1.8 in the fentanyl sedation group.
conclusionsTopical anaesthesia was associated with more cardiorespiratory instability during ROP laser treatment. While general anaesthesia and fentanyl sedation had similar postoperative cardiorespiratory results, the latter demonstrated acceptable pain stress control. However, the difficulty of weaning off mechanical ventilation in some cases after surgery needs to be addressed in future studies.
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