BACKGROUND: The aim of our study was to compare the analgesic/sedative effects of various fundus-related procedural pain management strategies on the risk of retinopathy in premature infants. METHOD: This was a prospective comparative study involving a total of 94 neonates randomized to three groups meeting the criteria for at-risk neonates. Ophthalmologic screening was performed to evaluate the outcome of three procedural pain management strategies. The intensity of pain over time during and after the screening examination was evaluated. At the same time, we also looked at the occurrence of vegetative symptoms and their influence by the chosen medication. Pain response was observed in all 94 neonates enrolled in the study. In group A, no pain treatment was given. Group B had a local anesthetic oxybuprocaine hydrochloride 0.4% introduced into both eyes immediately prior to the examination. Group C received oral clonidine. The study was conducted as a pilot project and aimed to clarify the problem so that a project with a higher proband representation could take place in the future. Consequently, we performed quantitative analysis of complete pain and vegetative functions, followed by a qualitative analysis of their internal components. RESULTS: In our study, we identified the most considerable effects for all three groups, including NIPS (Neonatal Infant Pain Scale) responses immediately during and after the examination. The influence of vegetative functions is of a longer-term nature and increased values can be clearly demonstrated even six hours after the examination. CONCLUSION: The current results identify and quantify differences among all three methods of pain treatment on the level of single variables. Their internal structures, however, can be analysed only qualitatively because of the small size of the analysed sample.

Department of Mathematics College of Polytechnics Tolsteho 16 586 01 Jihlava Czech Republic

Faculty of Health and Social Sciences University of South Bohemia J Boreckeho 1167 370 11 Ceske Budejovice Czech Republic

Faculty of Management Prague University of Economics and Business Jarosovska 1117 2 377 01 Jindrichuv Hradec Czech Republic

Institute of Experimental Medicine Academy Sciences of the Czech Republic Videnska 1083 142 20 Prague Czech Republic

Neonatology Department Ceske Budejovice Hospital Bozeny Nemcove 54 370 01 Ceske Budejovice Czech Republic

Pediatrics Department Ceske Budejovice Hospital Bozeny Nemcove 54 370 01 Ceske Budejovice Czech Republic

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