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Related Experiment Videos

Opioids for neonates receiving mechanical ventilation.

R Bellù1, K A de Waal, R Zanini

  • 1Neonatal Intensive Care Unit, Ospedale "Manzoni" -Lecco, Via Eremo 9, Lecco, Italy, 23900. r.bellu@ospedale.lecco.it

The Cochrane Database of Systematic Reviews
|January 28, 2005
PubMed
Summary
This summary is machine-generated.

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See all related articles

Opioid analgesics may reduce pain in newborns on mechanical ventilation but evidence is limited. Routine use is not recommended; selective use based on pain indicators is advised, with morphine being safer than midazolam for sedation.

Area of Science:

  • Neonatal intensive care
  • Pediatric pharmacology
  • Pain management

Background:

  • Mechanical ventilation is a common, yet painful, procedure in neonatal intensive care units.
  • Newborn infants are highly sensitive to pain, which can negatively impact neurodevelopmental outcomes.
  • Effective pain management is crucial for improving clinical outcomes in neonates.

Purpose of the Study:

  • To evaluate the efficacy of opioid analgesics compared to placebo, no treatment, or other sedatives/analgesics.
  • To assess the impact of opioids on pain, duration of mechanical ventilation, mortality, growth, and neurodevelopmental outcomes in neonates.
  • To provide evidence-based recommendations for opioid use in mechanically ventilated newborns.

Main Methods:

  • Systematic review and meta-analysis of randomized and quasi-randomized controlled trials.

Related Experiment Videos

  • Searches conducted across major databases including Cochrane CENTRAL, MEDLINE, EMBASE, and CINAHL.
  • Data extraction and analysis performed independently by two reviewers using appropriate statistical models (fixed or random effects).

    • Main Results:

    • Opioid administration was associated with reduced pain scores (Premature Infant Pain Profile - PIPP) in neonates.
    • No significant differences were observed in mortality, duration of mechanical ventilation, or neurodevelopmental outcomes.
    • Very preterm infants receiving morphine experienced delays in achieving full enteral feeding.

    Conclusions:

    • Insufficient evidence exists to support the routine use of opioids in mechanically ventilated newborns.
    • Opioids should be utilized selectively, guided by clinical judgment and pain assessment.
    • Morphine is considered a safer option for sedation compared to midazolam in this population.