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[Pethidine analgesia and cerebrovascular circulation in very small premature infants]
Insights
Pethidine analgesia did not significantly affect cerebral blood flow in preterm infants. This study supports the use of morphine derivatives for pain management in neonates, as they are well-tolerated.
Area of Science:
- Neonatalogy
- Pharmacology
- Pediatric Neurology
Context:
- Preterm infants experience pain, necessitating effective analgesia.
- Assessing the safety of analgesics on cerebral circulation is crucial for vulnerable neonates.
- Pethidine is a commonly used opioid analgesic.
Purpose:
- To evaluate the effects of pethidine on intracerebral circulation in very immature preterm infants.
- To measure blood flow velocity in key cerebral arteries (internal carotid, basilar, anterior cerebral) after pethidine administration.
- To assess physiological parameters including mean arterial blood pressure, heart rate, and tcpCO2.
Summary:
- Pulsed Doppler sonography was used to measure cerebral blood flow in 10 preterm infants (24-30 weeks gestational age) before and after intravenous pethidine (1.0 mg/kg).
- No significant changes were observed in blood flow velocity in the internal carotid artery, basilar cerebral artery, or anterior cerebral artery.
- Mean arterial blood pressure, heart frequency, and tcpCO2 also remained unchanged, indicating pethidine's tolerance in this population.
Impact:
- This study demonstrates the safety of pethidine regarding cerebral hemodynamics in extremely preterm infants.
- It supports the use of morphine derivatives for neonatal pain management, highlighting their tolerability.
- Provides evidence-based guidance for pain management strategies in neonatal intensive care units.
Abstract:
Aim of the study was the assessment of possible side effects of analgesia with pethidine on the intracerebral circulation of very immature preterm infants. For this purpose the blood flow velocity in the internal carotid artery, basilar cerebral artery and the anterior cerebral artery was measured by pulsed Dopplersonography before and 5-10 min after i.v. injection of 1.0 mg/kg pethioine on 10 preterm infants with a gestational age of 24-30 weeks. Furthermore values for the parameter mean arterial blood pressure, heart frequency and tcpCO2 were obtained. None of the measured parameters showed a significant difference with the i.v. bolus injection of pethidine. As even very immature preterm infants do feel pain and can show potential dangerous physiological pain reactions and as this study proves the tolerance of the drug, analgesia with morphine derivates is recommended.