The addition of multisensory pain-reducing interventions to topical anesthetic (TA) reduces pain in eye examinations of preterm infants, according to research published online June 1 in Pediatrics

Research conducted to combine randomized trials of pain-relieving interventions for retinopathy of prematurity examinations using network meta-analysis.

Timothy Disher, Ph.D., from Dalhousie University in Halifax, Canada, and colleagues conducted a systematic literature review to identify randomized trials of pain-relieving interventions for retinopathy of prematurity examinations.

Researchers procured data from Systematic review and network meta-analysis of Medline, Embase, Cochrane Central Register of Controlled Trials, Web of Science, and the World Health Organization International Clinical Trials Registry Platform. All databases were searched from inception to February 2017.

Primary and secondary outcome

Topical anesthetic (TA) combined with sweet taste, and an adjunct intervention (e.g., nonnutritive sucking) had the highest probability of being the optimal treatment (mean difference [95% credible interval] versus TA alone = −3.67 [−5.86 to −1.47]; surface under the cumulative ranking curve = 0.86).

Secondary outcomes were sparsely reported (2–4 studies, N = 90–248) but supported sweet-tasting solutions with or without adjunct interventions as optimal.

There was sparse reporting of secondary outcomes in only two to four studies; however, they did support sweet-tasting solutions with or without adjunct interventions as optimal.

Limitations included moderate heterogeneity in pain assessment reactivity phase and severe heterogeneity in the regulation phase.

"Despite limitations, there are consistent trends suggesting that the addition of multisensory pain-reducing interventions with TA results in an improved reduction in pain response to eye examinations in preterm infants," the authors write.

"Given the less than the optimal efficacy of current treatments, it is imperative that future researchers investigate novel approaches to reduce pain associated with eye examinations in preterm infants."