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Morphine and Methadone for Neonatal Abstinence Syndrome: A Systematic Review
Neonatal Network : NN
|December 21, 2018
Summary
This systematic review found limited evidence comparing morphine and methadone for neonatal abstinence syndrome (NAS). Both drugs showed variable effects on length of hospital stay (LOS) and treatment (LOT), with no clear advantage for either.
Area of Science:
- Neonatal care
- Pharmacology
- Evidence-based medicine
Background:
- Neonatal Abstinence Syndrome (NAS) is a growing concern.
- Opioid withdrawal in newborns requires effective management.
- Morphine and methadone are common treatments for NAS.
Purpose of the Study:
- To compare the efficacy of morphine versus methadone in treating NAS.
- To evaluate the impact of these treatments on length of hospital stay (LOS) and length of treatment (LOT).
- To assess the incidence of adverse effects associated with morphine and methadone in NAS infants.
Main Methods:
- A systematic review of randomized controlled trials (RCTs) and observational studies.
- Searches conducted across major databases including PubMed, Google Scholar, Cochrane Library, CINAHL, IPA, and clinicaltrials.gov.
- Inclusion criteria focused on studies comparing morphine and methadone for NAS treatment.
Main Results:
- The review included one RCT and three observational studies with low risk of bias.
- Length of hospital stay (LOS) varied: 12.08–36 days for morphine and 21–44.23 days for methadone.
- Length of treatment (LOT) also varied: 7.46–22.9 days for morphine and 13.9–38.08 days for methadone.
- Adverse effects were not consistently reported across studies.
Conclusions:
- Current clinical evidence comparing morphine and methadone for NAS is limited and conflicting.
- A definitive recommendation for one agent over the other cannot be made based on available data.
- Further high-quality research is needed to guide treatment decisions for NAS.
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