Opioids for procedural pain in neonates

Kinoshita, Mari; Olsson, Eva‐Karin; Borys, Franciszek; Bruschettini, Matteo

doi:10.1002/14651858.cd015056.pub3

Cited by 2 publications

(3 citation statements)

References 111 publications

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“…However, existing evidence cannot clarify the effect of opioids on episodes of bradycardia, hypotension, or apnea [90,103]. Thus no definite conclusion could be reached concerning the potential effect of opioids, in general, or fentanyl per se, on blood pressure in preterm and term infants [90,103]. A longterm study of infants treated with fentanyl early after birth did not find any significant correlation between cumulative fentanyl exposure and neurodevelopmental outcomes at five years of age [107].…”

Section: Fentanylmentioning

confidence: 99%

“…Overall, the use of specific pain scales in neonates revealed that opioids reduce procedural pain. However, there is a considerable uncertainty regarding the relationship of opioids with episodes of bradycardia, hypotension, or severe apneas [90]. Therefore, the use of standardized protocols for pain management have been suggested to minimize the exposure to opioids [87,91].…”

Section: Opioidsmentioning

confidence: 99%

“…A recent Cochrane review including 13 independent studies (enrolling 823 newborn infants) concluded that opioids probably are more effective in reducing pain scores than placebo. However, existing evidence cannot clarify the effect of opioids on episodes of bradycardia, hypotension, or apnea [90,103]. Thus no definite conclusion could be reached concerning the potential effect of opioids, in general, or fentanyl per se, on blood pressure in preterm and term infants [90,103].…”

Section: Fentanylmentioning

confidence: 99%

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Antibiotic Analgesic-Sedative and Antiseizure Medications Frequently Used in Critically Ill Neonates: A Narrative Review

Kontou,

Agakidou,

Chatziioannidis

et al. 2024

Preprint

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Several studies have shown that antibiotics, analgesic – sedative, and antiseizure medications are among the most commonly used medications in preterm and sick neonates. These infants are at high risk of developing nosocomial infections, central nervous system complications, and are exposed to numerous painful/stressful procedures. These severe, potentially life-threatening complications may have serious short- and long-term consequences and should be prevented and/or promptly treated. Previous studies and reviews have revealed significant variability in medications used in neonatal intensive care units (NICUs) worldwide, especially concerning the indications and dosages of first-line medications. This variability indicates the lack of adequate studies regarding the effectiveness and safety of these medications in neonates, especially the preterm ones. Important obstacles contributing to inadequate studies in preterm infants include difficulties in obtaining parental consent, physicians’ unwillingness to recruit preterm infants, the lack of license for use in neonates, and other scientific and ethical concerns. This review is an update on the use of antimicrobials – antifungals, analgesics – sedatives, and antiseizure medications used in neonates, focusing on existing evidence or knowledge gaps regarding their pharmacokinetics, indications, safety, dosage regimen (dose, dosing interval, route of administration), and evidence-based guidelines for the optimal use in neonates.

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