Postoperative pain in neonates in Canadian NICUs appears to be consistently treated, primarily with opioid analgesics, but analgesia, opioid or nonopioid is rarely given for nonsurgical invasive procedures.

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SUMMARY The developmental changes in caffeine elimination were studied in 7 infants aged between 21 weeks and 6 months. Adult plasma clearance rate of caffeine was achieved at 3 to 41 months of age. Plasma half-life and elimination rate reached adult levels after 3 to 41 months and seemed to exceed adult capacity thereafter. No significant changes in apparent volume of distribution were noted. Our data provide some indication of the age in infancy when the low rates of caffeine elimination in the neonate increase to the adult rate.

Summarvuse could potentially result in an increase in plasma free fatty Net nitrogen retention (NNR) and rates of whole-body protein turnover (Q), synthesis, and breakdown (B) were measured in 24 intravenously fed premature infants, birthweight

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Drug exposures in neonates admitted to a neonatal intensive care unit in 1974 and in 1977 were compared. A significant increase in drug exposure (3.4 drugs per baby in 1974 versus 6.19 drugs in 1977) and in the total number of drugs used (71 versus 102 different drugs) were noted. The proportion of infants receiving no drugs were similar (23%). Infants given penicillin and kanamycin decreased by about 50% with a reciprocal increase observed with ampicillin and gentamicin. Except for a few drugs (chloramphenicol, methicillin, Infantol), all drugs were used in a greater number of babies in 1977. Data indicate increase in drugs used and a change in the pattern of drug utilization over a period of three years.

A prospective study on the epidemiology of adverse drug reactions (ADR) in the 200 neonates consecutively admitted to a newborn intensive care unit had shown that 136 ADR occurred in 60 babies (incidence = 30%). 20 of these ADR (14.7%) were major (life-threatening), 34 (25 %) were moderate (prolonged hospital stay) and 82 (60.3 %) were minor (resolved spontaneously, no therapy required). Respiratory depression, cardiac arrhythmias, renal failure, metabolic abnormalities (hyperglycemia, electrolyte imbalance) and gastrointestinal bleeding were the most common major and moderate ADR. Hematologic (eosinophilia, thrombocytopenia) and metabolic (lipemia, hyperglycemia) were the most frequent minor ADR. The case fatality rate is 5 %. Most commonly suspected drugs associated with the ADR were cardiovascular drugs (tolazoline, digoxin, methoxamine), antibiotics, diuretics and components of intravenous nutrition solutions.