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Intranasal Fentanyl Use in Neonates.
Sonia Kaushal1, Jennifer L Placencia2, Salvador R Maffei1
1Baylor College of Medicine, Houston, TX, USA.
Hospital Pharmacy
|March 28, 2020
Summary
Intranasal fentanyl (INF) is increasingly used in neonatal intensive care units (NICUs) for procedural sedation and analgesia. This study found the typical starting dose for INF in NICU patients is 1.5 µg/kg, usually administered as a single dose.
Area of Science:
- Neonatal Medicine
- Pediatric Pharmacology
- Pain Management
Background:
- Intranasal medication offers an alternative to intravenous lines for procedural sedation and analgesia.
- Intranasal fentanyl (INF) use is expanding beyond prehospital and emergency settings into neonatal intensive care units (NICUs).
- Limited data exists on INF utilization in neonates, necessitating further investigation.
Purpose of the Study:
- To describe the trends and patterns of intranasal fentanyl use in a neonatal intensive care unit (NICU).
- To analyze patient demographics and medication administration details for INF in the NICU setting.
Main Methods:
- Retrospective cohort study of patients receiving INF in a NICU from December 2014 to December 2017.
- Data abstracted included gestational age, post-menstrual age, day of life, sex, dosage, indication, and adverse events.
- Study approved by the institutional review board.
Main Results:
- A total of 54 patients received 67 INF administrations.
- Median day of life for administration was 57.1 days, with a median gestational age of 26.0 weeks.
- The initial dose of intranasal fentanyl was typically 1.5 µg/kg (range 0.5-2 µg/kg).
Conclusions:
- Intranasal adjuncts, including fentanyl, are becoming more prevalent in NICU care.
- The established starting dose for intranasal fentanyl in this NICU population is 1.5 µg/kg.
- Most administrations involved a single dose of intranasal fentanyl.
Keywords:
adverse drug reactions reporting/monitoringanalgesicsclinical pathwaysclinical servicesdrug/medical use evaluationpain managementpediatricsMore Related Videos
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