Post-procedure pain in preterm neonates undergoing retinopathy of prematurity (ROP) screening: A prospective cohort study

Abstract Objectives: To evaluate the pain intensity during 48 hours post retinopathy of prematurity (ROP) screening. Design: Prospective cohort study Settings: Level-III NICU in India Participants: 83 Neonates undergoing first ROP screening Main outcome measures: Pain assessment using the premature infant pain profile-revised (PIPP-R) score at baseline and 5minutes, 30minutes, 6-, 24-, and 48-hours post-procedure. Results: The mean gestation and birth weight was 29.8(2.3) weeks and 1256(344) g respectively. The median (IQR) PIPP-R score at baseline was 0 which significantly increased to 10.5(8,12.5) 5min (immediately) after the procedure. At 30min and 6hours, scores were 7(5,8) and 4.5(3,5.5) respectively. After 24 and 48hours, it decreased to 3(0,5) and 0(0,4.5) respectively. Nearly 59%(95% CI:40%–83%) of neonates had severe pain (PIPP-R score>12). Conclusion: A majority of neonates experience severe pain immediately after ROP screening and mild-moderate pain continues for 6 hours, hence an additional pharmacological agent should be considered for reducing neonatal pain.