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01 April 2010

Perioperative analgesia of infants during the therapy for retinopathy of prematurity

Eva GorbeAB, Rita VamosB, Gabor Jozsef JooE, Judit JeagerBF, Attila MolvarecC, Botond BereczEF, Adrienn HorvathEF, Balint SulyaFG, Janos Jr. RigoD

Med Sci Monit 2010; 16(4): CR186-189 :: ID: 878500

Abstract

Background
In this retrospective investigation, we compared the main anesthesiologic aspects in the preoperative, perioperative, and postoperative care of 2 different surgical methods (cryotherapy, laser coagulation) for retinopathy of prematurity.
Material and Method
A retrospective analysis of analgesia for retinopathy of prematurity was performed for a 14-year period. Infants treated from January 1994 to December 2007 were involved in the study. Before 1997, we performed transconjunctival cryotherapy with ketamine analgesia for 28 newborn infants, while in the last 10 years, laser photocoagulation was done with nalbuphine-diazepam analgesia in 85 cases.
Results
Significant differences were verified in gestational age of birth in the group of retinopathy of prematurity patients treated with cryotherapy compared with those treated with laser coagulation 27.9+/-2.7 weeks vs 26.4+/-2.4 weeks (P<.05). The difference in the need for postoperative ventilation (43% vs 19%; P<.05) as well as the number of cases with hypoxemia (54% vs 21%; P<.05) was significant, compared with the group of infants treated with cryotherapy with those treated with laser coagulation.
Conclusions
This study demonstrates that intravenous analgesia (with ketamine or nalbuphine-diazepam) can be used in the surgical treatment of retinopathy of prematurity.

Keywords: preoperative period, Retinopathy of Prematurity - therapy, Postoperative Period, Nalbuphine - therapeutic use, Lasers, Laser Coagulation - methods, Ketamine - therapeutic use, Infant, Newborn, Diazepam - therapeutic use, Cryotherapy - methods, Anesthesiology - methods, Analgesia - methods

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