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

Oleh:

Saarenmaa, Elina ; Huttunen, Pirkko ; Leppaluoto, Juhani ; Meretoja, Olli ; Fellman, Vineta

Jenis: Article from Journal - ilmiah internasional
Dalam koleksi: The Journal of Pediatrics vol. 135 no. 02 (Feb. 1999), page 144-150 .
Topik: IQR ; Interquartile range

Ketersediaan

Perpustakaan FK Nomor Panggil: J45.K.1999.02 Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

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Isi artikel

Objective: To compare the efficacy and adverse effects of fentanyl or morphine analgesia during the first 2 days of life in newborn infants who underwent mechanical ventilation. Study design: In a randomized double-blind trial, 163 infants were allocated to receive a continuous infusion of fentanyl (10.5 µg/kg over a 1-hour period followed by 1.5 µg/kg/hr) or morphine (140 µg/kg over a 1-hour period followed by 20 µg/kg/hr) for at least 24 hours. The severity of pain was assessed with physiological parameters, a behavioral pain scale, and stress hormone concentrations before and 2 and 24 hours after the start of treatment. Results: The analgesic effect was similar in both groups, as judged by the pain scale. Plasma adrenaline and noradrenaline concentrations decreased significantly from 0 to 24 hours in both groups. Median adrenaline decrease was –0.5 nmol/L (interquartile range [IQR] –1.1;0.0) in the fentanyl and –0.7 nmol/L (IQR –1.3;0.1) in the morphine group, noradrenaline –2.1 nmol/L (IQR –9.0;0.2), and –3.0 nmol/L (IQR –7.5;0.3), respectively. ß-endorphin decreased significantly only in the fentanyl group (–14 pmol/L (IQR –28;–7), P < .05). Decreased gastrointestinal motility was less frequent in the fentanyl group (23% vs 47%, P < .01). Conclusions: With at least as effective analgesia as with morphine, fentanyl had fewer side effects. Fentanyl may be superior to morphine for short-term postnatal analgesia in newborn infants.

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