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Background: Preterm infants are at risk for neurodevelopmental deficits. An association between retinopathy of prematurity (ROP) and impaired cognitive outcome has already been described. However, less is known about the impact of ROP on visual motor integration (VMI), which is a prerequisite not only for fine motor abilities but also for further school skills. Therefore, the aim of this study was to retrospectively investigate the impact of ROP on VMI at preschool age., Methods: The study was conducted at the Medical University of Vienna, including patients born between January 2009 and December 2014 with a gestational age of less than 30 weeks and/or a birth weight of less than 1,500 g. VMI was determined by Beery-Buktenica Developmental Test of Visual Motor Integration (Beery VMI) at the age of 5 years., Results: Out of 1,365 patients, 353 met inclusion criteria for this study. Two hundred sixteen of them had no ROP, while 137 had ROP (stage 1: n = 23, stage 2: n = 74, stage 3: n = 40). Mean value of the Beery VMI score was significantly lower in the ROP group compared to the No-ROP group (90 ± 16 vs. 99 ± 14; p < 0.01). By correcting for other important medical conditions, ROP still had a significant impact on Beery VMI score (p < 0.01). Particularly, lower scores were found for stage 2 (p < 0.01) and stage 3 (p < 0.01)., Conclusion: Beery VMI scores were significantly lower in preterm infants with ROP stage 2 and 3 than in infants without ROP. This study shows the negative impact of ROP on VMI skills at preschool age, even after adjustment for key demographic and medical characteristics., (© 2023 The Author(s). Published by S. Karger AG, Basel.)

Previous studies have shown that bolus doses of fentanyl (50 and 100 micrograms) with epidural bupivacaine delay gastric emptying by up to 45 min. We studied the effect of the addition of small-dose fentanyl to epidural bupivacaine infusions on gastric emptying during labor. The acetaminophen absorption technique was used to infer gastric emptying. Twenty-eight patients in established labor consented to participate in the study. They were randomized to receive either 1) 10 mL bupivacaine 0.125% followed by an infusion of 0.125% bupivacaine at 10 mL/h or 2) 10 mL bupivacaine 0.125% with 50 micrograms fentanyl followed by an infusion of 0.125% bupivacaine and 0.0002% fentanyl at 10 mL/h. Two hours after initiation of epidural analgesia, each patient ingested 20 mg/kg acetaminophen in a suspension of 150 mL water. Venous blood samples were drawn for a baseline and then every 15 min for 2 1/2 h. There were no significant demographic differences between the groups. There were no differences detected between groups in the peak plasma concentrations of acetaminophen, the time to achieve the peak plasma concentrations, or the area under the curve at 45 and 90 min. Our results indicate that epidural infusions for labor analgesia using 0.125% bupivacaine and 0.0002% fentanyl do not delay gastric emptying compared to infusions of bupivacaine 0.125% alone.

A survey of postoperative pain management practices was mailed to the 56 Canadian university-affiliated teaching hospitals in December 1991. The aims of the survey were (1) to determine the prevalence, structure, and function of Acute Pain Services and (2) to determine the use and management of patient-controlled analgesia (PCA) and epidural opiate analgesia (EOA) in teaching hospitals. Responses were received from 47 hospitals, representing a return rate of 84%. Twenty-five hospitals (53%) operated an Acute Pain Service and an additional 17 (35%) were attempting to organize one. "Time commitment" was given as the primary reason why hospitals were unable to offer an Acute Pain Service. Most commonly used methods of pain relief were EOA and PCA. Most services were multidisciplinary, with 60% having a nurse and 29% a pharmacist. Irrespective of the presence of an Acute Pain Service, PCA was used at 32 (68%) hospitals, and EOA was used at 41 (87%); however, only 15 provided EOA on general wards. Complications have occurred with both PCA and EOA, with 14 of 32 hospitals indicating that they have had a major or serious complication. The data suggest an estimated incidence of severe respiratory depression of 0.03% with PCA and 0.13% with EOA. No deaths were reported at the time of the survey. Epidural opioid-local anaesthetic EOA-LA combinations were used at 26 (63%) hospitals; however, only six administered these combinations on general words. We conclude that a multidisciplinary team approach to manage postoperative pain is viable in university teaching hospitals of all sizes.(ABSTRACT TRUNCATED AT 250 WORDS)