Advantages of fentanyl over morphine in analgesia for ventilated newborn infants after birth: A randomized trial

Saarenmaa, E; Huttunen, Pirkko; Leppäluoto, Juhani; Meretoja, O. A.; Fellman, Vineta

doi:10.1016/s0022-3476(99)70407-5

Cited by 145 publications

(87 citation statements)

References 31 publications

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“…38,39 Morphine causes some histamine release and may lead to several side effects as a result. 29 For those infants on fluid restriction for patent ductus arteriosus (PDA) and those on diuretics, morphine will produce some degree of hypotension.…”

Section: Morphinementioning

confidence: 99%

“…42 More recently, in a blinded study of morphine versus placebo, there was no change in the response to heel sticks before and after a loading dose (100 mcg/kg followed by an infusion of 10 to 30 mcg/kg/h) of morphine on two different pain scales (PIPP and DAN scales). 38 There are some data suggesting that acute pain leads to an uncoupling of opiate receptors in the forebrain. 43 In the case of preterm infants, immaturity of opiate receptors could be a reason for the lack of response.…”

Section: Morphinementioning

confidence: 99%

“…47 The potency ratio of fentanyl compared to morphine is different in adults (80 to 100 times) as compared to infants (13 to 20 times). 38 Tolerance develops rapidly, especially with infusions compared to boluses. In addition, the risk of dependence and withdrawal is greater as compared to morphine.…”

Section: Fentanylmentioning

confidence: 99%

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Pharmacological approaches to the management of pain in the neonatal intensive care unit

Anand

2007

J Perinatol

103

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Effective and consistent management of neonatal pain remains a controversial issue.Premature infants are repeatedly subjected to painful tests and procedures or suffer painful conditions when they are most vulnerable. With different mechanisms transducing various types of pain the practice of 'one-drug fits all' becomes questionable.Clinicians must use the latest non-pharmacologic and pharmacologic therapies for effective management of neonatal pain, distress, or agitation. Pharmacologic strategies for dealing with neonatal pain in the neonatal intensive care unit are described. Opioid therapy, once considered the mainstay for neonatal analgesia, may not be as effective as previously thought. Morphine infusions do not alter the neurological outcomes of preterm neonates and may not be effective against acute pain. Alternative approaches with methadone, ketamine, or local anesthetics should be considered. Clinicians must understand the contextual circumstances underlying pain in individual neonates and tailor therapy accordingly, using the most current evidence related to neonatal pain assessment and management.

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Section: Morphinementioning

confidence: 99%

Section: Morphinementioning

confidence: 99%

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Pharmacological approaches to the management of pain in the neonatal intensive care unit

Anand

2007

J Perinatol

103

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“…It was prescribed with a loading dose of 2 mcg, and with a maintenance dose of 0.25 mcg/kg/hour, intravenously injected slowly. These dose adjustments were being administered based on experience from previous studies and reference book resources (10,13).…”

Section: Study Populationmentioning

confidence: 99%

“…Strong opioids such as morphine or fentanyl are frequently used in NICUs for reducing pain induced during these invasive procedures (7,8). The best chosen opioid is the one with the strongest analgesic effect and minimal side effects (9,10). It has been established that fentanyl is 50 -100 times more potent than morphine in terms of pain reduction (11,12).…”

Section: Introductionmentioning

confidence: 99%

Effect of Fentanyl and Morphine on Gallbladder Dimensions in Newborns Admitted to the Neonatal Intensive Care Unit: A Randomized Double-Blinded Clinical Trial

Naderi

Goodarzi

Naziri³

et al. 2017

Iran J Pediatr

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Background: The effect of fentanyl and morphine, two most frequently used drugs for premedication in general anesthesia, on gallbladder of newborns, has not been sufficiently investigated. Intubation and mechanical ventilation in a neonatal respiratory distress syndrome are stressful procedures, in which these two drugs are used to reduce stress and pain. We studied the effect of these drugs on neonatal bile system during these procedures

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Consensus Statement for the Prevention and Management of Pain in the Newborn

Anand

2001

Arch Pediatr Adolesc Med

721

477

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Advantages of fentanyl over morphine in analgesia for ventilated newborn infants after birth: A randomized trial

Cited by 145 publications

References 31 publications

Pharmacological approaches to the management of pain in the neonatal intensive care unit

Pharmacological approaches to the management of pain in the neonatal intensive care unit

Effect of Fentanyl and Morphine on Gallbladder Dimensions in Newborns Admitted to the Neonatal Intensive Care Unit: A Randomized Double-Blinded Clinical Trial

Consensus Statement for the Prevention and Management of Pain in the Newborn

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