Gabapentin Use for Hospitalized Neonates

Abdi, Hibo H.; Maitre, Nathalie L.; Benninger, Kristen; Hester, Mark E.; Slaughter, Jonathan L.

doi:10.1016/j.pediatrneurol.2019.02.012

Cited by 14 publications

(6 citation statements)

References 37 publications

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“…Немовлята з шлунково-кишковими захворюваннями в анамнезі з або без супутніх неврологічних захворювань можуть страждати від вісцеральної гіпералгезії, яка клінічно проявляється дратівливістю, гіпертонусом м'язів та/або непереносимістю їжі без чіткої етіології після діагностичного обстеження. У цих немовлят габапентин може зменшувати дратівливість та покращувати засвоєння їжі [36].…”

Section: результати та їх обговоренняunclassified

Anesthesia or Sedation of Newborns in Intensive Care: How to Determine the Optimal Way?

Tsvirenko¹,

Tarasenko²,

Adamchuk³

et al. 2022

Act. Probl. of the Modern Med.

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During their stay in the intensive care unit, newborns are subjected to an enormous number of painful procedures and operations. Poorly treated pain during the newborn period can lead to negative remote effects such as cognitive dysfunction, the formation of chronic pain. Therefore, every day reanimatologists accept the challenge to evaluate the pain adequately and to choose right analgesia tactics. The literature review represents the analysis of 87 literary sources over the past 10 years. This article covers the results of multicenter studies and clinical recommendations. It has been determined that optimal treatment of pain and anxiety in newborns requires a multimodal approach, always including non-medication strategies and directed primarily to analgesia. Placing on the chest and breastfeeding, sucking reflex, «skin to skin» contact, «kangaroo» care, swaddling – all these aspects of childcare are effective to reduce physiological and behavioural response to pain in invasive procedures, and also have sedative effect. Every manipulation requires a mandatory analgesic. The choice of the method of anesthesia depends on the invasiveness of the procedure, gestational age and the severity of the condition of the child. It is advisable to combine various non-medication analgesic methods for mild pain, to add medication methods for moderate and severe pain to achieve better therapeutic effect. Neonates who are on prolonged ventilation cannot avoid sedation. However, sedation can be achieved by a combination of non-medication methods and sedatives. In order to prevent tachyphylaxis, analgesics should be rotated, and combinations of opiates with non-narcotic analgesics and adjuvant analgesics should be used. The multimodal approach to pain treatment has the benefits of reducing the dosage of any single drug and mitigating the overall risk of side effects. Acetaminophen, fentanyl or morphine in combination with midazolam are the safest medicines for use in newborns, despite the side effects.

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Section: результати та їх обговоренняunclassified

Anesthesia or Sedation of Newborns in Intensive Care: How to Determine the Optimal Way?

Tsvirenko¹,

Tarasenko²,

Adamchuk³

et al. 2022

Act. Probl. of the Modern Med.

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“…However, some of these medications can be effective at treating agitation or neuroirritability. Gabapentin, which works on the voltage dependent calcium channel, can be beneficial for neonates with difficult to control agitation or neuroirritability (68)(69)(70)(71).…”

Section: Classes Of Commonly Used Medicationsmentioning

confidence: 99%

Neonatal End-of-Life Symptom Management

Cortezzo

Meyer

2020

Front. Pediatr.

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Purpose of review: Despite advances in technology and treatment options, over 15,000 neonates die each year in the United States. The majority of the deaths, with some estimates as high as 80%, are the result of a planned redirection of care or comfort measures only approach to care. When curative or life-prolonging interventions are not available or have been exhausted, parents focus on preserving quality of life and eliminating needless suffering. Parents hope their child will have a peaceful death and will not feel pain. A significant component of end-of-life care is high quality symptom evaluation and management. It is important that neonatal providers are knowledgeable in symptom management to address common sources of suffering and distress for babies and their families at the end-of-life (EOL). Recent findings: Medically complex neonates with life-threatening conditions are a unique patient population and there is little research on end-of-life symptom assessment and management. While there are tools available to assess symptoms for adolescents and adults, there is not a recognized set of tools for the neonatal population. Nonetheless, it is widely accepted that neonates experience significant symptoms at end-of-life. Most commonly acknowledged manifestations are pain, dyspnea, agitation, and secretions. In the absence of data and established guidelines, there is variability in their clinical management. This contributes to provider discomfort and inadequate symptom control. Summary: End-of-life symptom assessment and management is an important component of neonatal end-of-life care. While there remains a paucity of studies and data, it is prudent that providers adequately manage symptoms. Likewise, it is important that providers are educated so that they can effectively guide families through the dying process by discussing disease progression, physical changes, and providing empathetic support. In this review, the authors make recommendations for non-pharmacological and pharmacological management of end-of-life symptoms in neonates.

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“…Benzodiazepines, opioids, barbiturates, acetaminophen, non‐steroidal anti‐inflammatory drugs, or dexmedetomidine are commonly used (often in combination) for pain management in newborn infants, with limited evidence available. Gabapentin has become increasingly popular, particularly for neurological disorders, irritability, and when chronic pain is suspected; however, there is currently little evidence on the safety, efficacy, potential long‐term effects on neurodevelopment, risk of dependency, and, overall, no consensus on the prescription for infants …”

mentioning

confidence: 99%

“…Gabapentin has become increasingly popular, particularly for neurological disorders, irritability, and when chronic pain is suspected; however, there is currently little evidence on the safety, efficacy, potential long-term effects on neurodevelopment, risk of dependency, and, overall, no consensus on the prescription for infants. 4 The paper by Burnsed et al 5 describes a small, retrospective, single-centre study in infants born preterm and at term with congenital abnormalities (mainly cardiac), in whom gabapentin was used for agitation, irritability, and/or pain. These were assessed before treatment and monitored with the Neonatal Pain, Agitation and Sedation Scale (N-PASS).…”

mentioning

confidence: 99%

“…This carefully conducted retrospective study and the recent survey of gabapentin use across North American neonatal intensive care units are two of the few clinical studies that focus on chronic pain and use a standardized tool for behavioural assessment. 4 These studies highlight some important problems relating to existing clinical neonatal pain management research in general: use of confusing terminologythe terms 'agitation', 'irritability', and 'pain' are often used interchangeablywhich makes it difficult to assess nociceptive stress accurately. There are almost always heterogeneous patient groups in these studies and, importantly, the stage of brain development at treatment is rarely considered, even though this may affect response to treatment and long-term outcome.…”

mentioning

confidence: 99%

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