Remifentanil Analgesia during Laser Treatment for Retinopathy of Prematurity: A Practical Approach in Neonatal Intensive Care Unit

Abstract

Background Retinopathy of prematurity (ROP) is a significant cause of childhood blindness.

Aim The aim of this study is to determine the feasibility of remifentanil analgesia during laser treatment of ROP performed in the neonatal intensive care unit (NICU).

Patients and Methods Remifentanil was infused continuously during the procedure starting with a dose of 0.2 µg/kg/min and increased gradually to 0.6 µg/kg/min to provide an adequate level of analgesia.

Results We enrolled 64 infants. Remifentanil was infused continuously at a mean rate of 0.4 ± 0.1 μg/kg/min. No major adverse effects were observed except in two patients with reversible bradycardia and hypotension. Premature infant pain profile (PIPP) scores revealed no pain. Patients with bronchopulmonary dysplasia had similar remifentanil dosage, intubation duration, and extubation time.

Conclusions Remifentanil analgesia for ROP treatment performed in the NICU by pediatricians is a safe and effective modality. This modality offers a practical solution in hospitals without readily available pediatric anesthetists.

Keywords

retinopathy of prematurity - laser photocoagulation - remifentanil - newborn - NICU

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