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New research · Ophthalmology
European journal of pediatrics · 4d
Systematic reviewEuropean journal of pediatrics · 2026

Efficacy and safety of procedural sedation-analgesia during laser photocoagulation for retinopathy of prematurity: a systematic review.

Satya Prakash, Deena Thomas, Shamnad Madathil, Deepika Kainth
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OphthalmologySystematic review

Apnea, especially with high-dose fentanyl, was the most common side effect during retinopathy of prematurity laser sedation.

Efficacy and safety of procedural sedation-analgesia during laser photocoagulation for retinopathy of prematurity: a systematic review.

Satya Prakash … Deepika Kainth
European journal of pediatrics · 2026
Background

UNLABELLED: Laser photocoagulation for retinopathy of prematurity (retinopathy of prematurity) in preterm infants causes significant procedural pain.

Purpose

This systematic review aimed to evaluate the efficacy and safety of procedural sedation-analgesia during laser photocoagulation for retinopathy of prematurity.

Methods

We searched MEDLINE, Embase, and Cochrane CENTRAL for trials investigating sedation-analgesic agents during laser photocoagulation.

n = 265
30%
Results
30%
about 1 in 3 infants had breathing pauses, worse with high-dose fentanyl
n = 265
More results

Primary outcome was analgesic efficacy (pain score reduction, rescue analgesics required).

Two reviewers extracted relevant information and assessed risk-of-bias using ROB2 and evidence certainty using GRADE methodology.

Of 540 articles screened, four relevant RCTs were identified (n = 265).

More results

REVIEW REGISTRATION: Prospectively registered on PROSPERO (CRD420251070146).

“
Conclusion · 1 of 2

Overall, the included studies were small RCTs evaluating varying combinations of interventions, precluding concrete conclusions about the superiority of any analgesic regimen during laser photocoagulation.

Conclusion · 2 of 2

Further high-quality studies are needed to identify safe and effective analgesia for settings where general anaesthesia is unavailable.

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