Withdrawal symptoms in children after long-term administration of sedatives and/or analgesics: a literature review. “Assessment remains troublesome”

Ista, Erwin; Dijk, Monique van; Gamel, Claudia; Tibboel, Dick; Hoog, Matthijs de

doi:10.1007/s00134-007-0696-x

Cited by 107 publications

(97 citation statements)

References 48 publications

(135 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Still, the signs and symptoms included in the SOS have been extensively described in the literature [3][4][5]12]. Also, the tenfold cross validation on children showed that the empirical solution was robust.…”

Section: Discussionmentioning

confidence: 99%

“…The first step was a review of the literature on withdrawal symptoms in critically ill children admitted to a PICU based on an extensive evaluation of the literature as recently published by our group [3]. Based on this review, we selected 24 signs and symptoms for inclusion in a preliminary scale, which we called the Sophia Benzodiazepine and Opioid Withdrawal Checklist (SBOWC).…”

Section: Methodsmentioning

confidence: 99%

“…Signs and symptoms of withdrawal can be categorized into three main groups: overstimulation of the central nervous system (CNS), gastrointestinal dysfunction, and autonomic dysregulation [1][2][3].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Construction of the Sophia Observation withdrawal Symptoms-scale (SOS) for critically ill children

et al. 2009

Self Cite

View full text Add to dashboard Cite

Objective: To construct a reliable and clinically practical instrument for monitoring opioids and benzodiazepine withdrawal symptoms in pediatric ICU patients. Design: Instrument development. Setting: Intensive care unit in an academic children's hospital. Patients and participants: 79 patients up to age 16 years on intravenous midazolam and/or opioids for C5 days. An expert panel of 85 physicians and nurses rated clinical relevance of withdrawal symptoms. Intervention: During drug weaning repeated observations were performed with a checklist of 24 withdrawal symptoms described in the literature. Measurements and results: For 76 children, 932 observations were obtained within 24 h after decrease and/or discontinuation of midazolam or opioids. Most frequent symptoms were tachypnea, agitation, motor disturbance, diarrhea, fever, anxiety, sleep disturbance and hypertension (14.6-29.6%). Multidimensional scaling (MDS) was performed to detect the underlying empirical structure of co-occurrences of symptoms. An expert panel judged clinical relevance of each withdrawal symptom on a four-point scale ranging from 'definitively so' to 'definitively not'. Agitation, anxiety, inconsolable crying, increased muscle tension, tremors, tachycardia and sweating were considered relevant by 85-95% of the experts. On the basis of the MDS results and the experts' opinions, 15 symptoms were included in the final instrument. Conclusions: We are the first to develop an assessment tool for withdrawal symptoms in pediatric ICU patients on the basis of the underlying empirical structure of co-occurrences of withdrawal symptoms that experts considered relevant. Future studies need to define cut-off points and clarify psychometric issues.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Construction of the Sophia Observation withdrawal Symptoms-scale (SOS) for critically ill children

et al. 2009

Self Cite

View full text Add to dashboard Cite

show abstract

“…Other investigators have emphasized that the Finnegan instrument common to all 3 studies has been validated only in term infants undergoing withdrawal secondary to in utero opioid exposure. 152,153 Therefore, the use of this tool may have underestimated withdrawal symptomatology in an older pediatric population. A third concern is that opioids and benzodiazepines are often used concurrently in the same patient, yet symptoms of opioid and benzodiazepine withdrawal overlap to a great extent.…”

Section: Management Of Acquired Opioid and Benzodiazepine Dependencymentioning

confidence: 99%

“…Hence, current instruments will not reliably differentiate whether withdrawal symptoms stem from relative opioid or benzodiazepine abstinence. 153 Other scales have been proposed for children and are in various stages of evaluation, including the Opioid and Benzodiazepine Withdrawal Scale, 151 the Sedation Withdrawal Score, 154 and the Sophia Benzodiazepine and Opioid Withdrawal Checklist. 155 At this time, no optimal pharmacologic regimen for the prevention or treatment of acquired opioid and/or benzodiazepine dependency can be recommended, because the necessary comparative studies of safety and efficacy are not available.…”

Section: Management Of Acquired Opioid and Benzodiazepine Dependencymentioning

confidence: 99%

Neonatal Drug Withdrawal

Hudak¹,

Tan²,

Frattarelli³

et al. 2012

Pediatrics

739

608

View full text Add to dashboard Cite

Maternal use of certain drugs during pregnancy can result in transient neonatal signs consistent with withdrawal or acute toxicity or cause sustained signs consistent with a lasting drug effect. In addition, hospitalized infants who are treated with opioids or benzodiazepines to provide analgesia or sedation may be at risk for manifesting signs of withdrawal. This statement updates information about the clinical presentation of infants exposed to intrauterine drugs and the therapeutic options for treatment of withdrawal and is expanded to include evidence-based approaches to the management of the hospitalized infant who requires weaning from analgesics or sedatives.

show abstract

Drug withdrawal: prevention and management

Saul¹

2023

The Great Ormond Street Hospital Manual of Children and Young People's Nursing Practices

View full text Add to dashboard Cite

Withdrawal symptoms in children after long-term administration of sedatives and/or analgesics: a literature review. “Assessment remains troublesome”

Cited by 107 publications

References 48 publications

Construction of the Sophia Observation withdrawal Symptoms-scale (SOS) for critically ill children

Construction of the Sophia Observation withdrawal Symptoms-scale (SOS) for critically ill children

Neonatal Drug Withdrawal

Drug withdrawal: prevention and management

Contact Info

Product

Resources

About