Efficacy of tramadol versus fentanyl for postoperative analgesia in neonates

Alencar, Ana Júlia Couto de; Sañudo, Adriana; Sampaio, Virginia Maria Ramos; Gois, Rosicler Pereira de; Benevides, Fernando Antônio Barbosa; Guinsburg, Ruth

doi:10.1136/adc.2010.203851

Cited by 25 publications

(15 citation statements)

References 34 publications

(35 reference statements)

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“…In another double-blind RCT, single doses of fentanyl (3 mcg/kg) reduced physiological and behavioral indicators of pain, improved postoperative comfort scores, and increased growth hormone levels in ventilated preterm neonates 136 . Among postoperative preterm infants, fentanyl and tramadol provided equally effective analgesia, with no differences between the two groups for the duration of mechanical ventilation or the time to reach enteral feeds 110 .…”

Section: Opioid Therapymentioning

confidence: 93%

“…They produce both analgesia and sedation, have a wide therapeutic window, and also attenuate the physiologic stress responses of neonates. Morphine and fentanyl are the most commonly used opioids, although some NICUs report the use of more potent (e.g., sufentanil) 105 , shorter acting (e.g., alfentanil 106,107 , remifentanil 108,109 ), or mixed opioids (e.g., tramadol 110 ).…”

Section: Opioid Therapymentioning

confidence: 99%

See 1 more Smart Citation

Pain Management in Newborns

Hall¹,

Anand

2014

Clinics in Perinatology

208

126

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Effective pain management is a desirable standard of care for preterm and term newborns and may potentially improve their clinical and neurodevelopmental outcomes. Neonatal pain should be assessed routinely using context-specific, validated and objective pain methods, despite the limitations of currently available tools. Reducing invasive procedures, and using pharmacological, behavioral or environmental measures can be used to manage neonatal pain. Non-pharmacologic approaches include kangaroo care, facilitated tucking, non-nutritive sucking, sucrose and other sweeteners, massage and acupuncture therapy. They are used for procedures causing acute, transient, or mild pain, or as adjunctive therapy for moderate or severe pain. Local and topical anesthetics can reduce the acute pain caused by skin-breaking or mucosa-injuring procedures. Opioids form the mainstay for treatment of severe pain; morphine and fentanyl are the most commonly used drugs, although other opioids are also available. Non-opioid drugs include various sedatives and anesthetic agents, mostly used as adjunctive therapy in ventilated neonates. Acetaminophen, ibuprofen and other drugs are used for neonates, although their efficacy and safety remains unproven. Approaches for implementing an effective pain management program in the Neonatal ICU are summarized, together with practical protocols for procedural, postoperative, and mechanical ventilation-associated neonatal pain and stress.

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Section: Opioid Therapymentioning

confidence: 93%

Section: Opioid Therapymentioning

confidence: 99%

Pain Management in Newborns

Hall¹,

Anand

2014

Clinics in Perinatology

208

126

View full text Add to dashboard Cite

show abstract

“…This is achieved in neonates by an infusion of approximately 100 mcg/kg/hour, which equates to 600 mcg/kg every 6 hours 24. More commonly used clinical dosing is twofold to threefold higher,13 at 100–200 mcg/kg/hour22 or 1–2 mg/kg every 6 hours 23. The dose a newborn receives from exposure to breast milk is therefore less than 5% of the therapeutic dose a neonate receives for analgesia (see table 1 for comparison with codeine).…”

Section: Tramadol Use Mechanism Of Action Metabolism and Excretion mentioning

confidence: 99%

Tramadol, breast feeding and safety in the newborn

et al. 2018

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“…28 This is also true for cytochrome P450 (CYP) 2D6 activity, of relevance for tramadol pharmacokinetics and -dynamics. 25–27 …”

Section: Newer Opioids In Neonates: New Is Better?mentioning

confidence: 99%

Pharmacological treatment of neonatal pain: In search of a new equipoise

Allegaert

Tibboel

Anker

2013

Seminars in Fetal and Neonatal Medicine

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SUMMARY Inadequate management of pain in early human life contributes to impaired neurodevelopmental outcome and alters pain thresholds, pain or stress-related behavior and physiological responses. However, there are also emerging animal experimental data on the impact of exposure to analgo-sedatives on the incidence and extent of neuro-apoptosis. Since this association has also been suggested in humans, the pharmacological treatment of neonatal pain is in search of a new equipoise since these ‘conflicting’ observations are the main drivers to further reconsider our current treatment regimens. This review focuses on new data concerning clinical pharmacology of morphine, followed by data on more recently introduced opioids like remifentanil and tramadol, locoregional anesthesia and minimally invasive techniques in neonates, and finally with data on intravenous paracetamol. Since the available data are still incomplete, priorities for both clinical management and future research will be proposed.

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Efficacy of tramadol versus fentanyl for postoperative analgesia in neonates

Abstract: Tramadol was as effective as fentanyl for postoperative pain relief in neonates but does not appear to offer advantages over fentanyl regarding the duration of mechanical ventilation and time to reach full enteral feeding. Trial registration NCT00713726.

Cited by 25 publications

References 34 publications

Pain Management in Newborns

Pain Management in Newborns

Tramadol, breast feeding and safety in the newborn

Pharmacological treatment of neonatal pain: In search of a new equipoise

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