Sedation during eye examinations in the NICU?

Hi,

We were discussing the practice of eye examinations in our unit in regards to infant discomfort. Right now we give cyclopentolate 0,5% -phenylephrin 0,5% drops, 1 in each eye, at 45 and 30 minutes before examination. If the opthalmologist chooses to do a full exam with RetCam they also give local anasthetics.

Since we see a lot of problems with desaturations and instability with the children post-exam, we are considering to only give 1 drop in each eye at 45 minutes pre-exam, this has been implemented at another hospital in the region. But we were also discussing the possibility of sedation during the exams to minimize discomfort of the infant.

A colleague suggested clonidine as an option, is that something you use, or how do you manage these issues?