Pain and stress assessment after retinopathy of prematurity screening examination Indirect ophthalmoscopy versus digital retinal imaging 英文参考文献.docVIP

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Pain and stress assessment after retinopathy of prematurity screening examination Indirect ophthalmoscopy versus digital retinal imaging 英文参考文献.doc

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Pain and stress assessment after retinopathy of prematurity screening examination Indirect ophthalmoscopy versus digital retinal imaging 英文参考文献

Moral-Pumaregaetal.BMCPediatrics2012,12:132 /1471-2431/12/132 RESEARCH ARTICLE OpenAccess Painandstressassessmentafterretinopathyof prematurityscreeningexamination:Indirect ophthalmoscopyversusdigitalretinalimaging MTeresaMoral-Pumarega1,SoniaCaserío-Carbonero1,JavierDe-La-Cruz-Bértolo1,2*,PilarTejada-Palacios1, DavidLora-Pablos2andCarmenRPallás-Alonso1 Abstract Background:Increasingly,neonatalclinicsseektominimizepainfulexperiencesandstressforprematureinfants. Fundoscopyperformedwithabinocularindirectophthalmoscopeisthereferenceexaminationtechniquefor screeningofretinopathyofprematurity(ROP),anditisassociatedwithpainandstress.Wide-fielddigitalretinal imagingisarecenttechniquethatshouldbeevaluatedforminimizinginfantpainandstress. Methods:Thepurposeofthestudywastoassessandcomparetheimpactofusingabinocularindirect ophthalmoscope(BIO),orwide-fielddigitalretinalimaging(WFDRI)onpainandstressininfantsundergoingROP screeningexamination.Thiswasacomparativeevaluationstudyoftwoscreeningprocedures.Ophthalmologic examinations(N=70)wereperformedon24infantswithbothBIOandWFDRI.Painassessmentswereperformed withtwospecificneonatalscales(Crying,requiresoxygen,increasedvitalsigns,expressionandsleeplessness,CRIES and,Prematureinfantpainprofile,PIPP)justpriortotheexamination,and30seconds,1hour,and24hourslater afterendingtheexamination. Results:ChangesovertimeweresignificantlydifferentbetweenBIOandWFDRIwithbothscales(PIPPscore, p=.007,andCRIESscore,p=.001).MedianPIPPscore(interquartileinterval)atbaselinewas4(3–5).At30seconds thescorewas8(6–9)forBIOand6(5–7)forWFDRI,respectively.TheincreaseinPIPPscorebetweenbaselineand 30secondswassignificantlylowerwithWFDRI(p=.006).ThemedianincreaseinCRIESscorefrombaselineto 30secondswas1pointlowerforWFDRIthanforBIO(p.001).Nosignificantdifferenceinresponseremainedat 1houror24hourassessments. Conclusions:Atransientshort-termpainandstressresponseoccurswithbothBIOandWFDRI.Infantsexamined forscreeningofROPwithdigitalretinalimagingpresentlesspainandstressa