Abstract:Objective To study the analgesic effect and safety of fentanyl in neonates receiving mechanical ventilation. Methods Thirty neonates receiving mechanical ventilation between December 2010 and February 2011 were randomized into drug intervention group and control group (n=15 each). In addition to the conventional treatment for both groups, the drug intervention group received fentanyl as the analgesic treatment. Heart rate, respiratory rate, blood pressure changes, and premature infant pain profile (PIPP) score before treatment and at 30 minutes, 2 hours, and 4 hours after treatment were recorded in both groups. Follow-up visits were performed for these infants after discharge, and the CDCC intellectual development scale for infants was applied to measure mental development index (MDI) and psychomotor development index (PDI) at 3, 6, 9, and 12 months of age. Results The respiratory rate and heart rate decreased in the drug intervention group after fentanyl treatment compared with the control group (PPP>0.05). Conclusions Fentanyl can relieve the pain response in neonates receiving mechanical ventilation, with no long-term adverse effects on neurodevelopment.
Nemergut ME, Yaster M, Colby CE. Sedation and analgesia to facilitate mechanical entilation[J]. Clin Perinatol, 2013, 40(3):539-558.
[2]
Zwicker JG, Grunau RE, Adams E, et al. Score for neonatal acute physiology-II and neonatal pain predict corticospinal tract development in premature newborns[J]. Pediatr Neurol, 2013, 48(2):123-129.
[3]
Ranger M, Chau CM, Garg A, et al. Neonatal pain-related stress predicts cortical thickness at age 7 years in children born very preterm[J]. PLoS One, 2013, 8(10):e76702.
[4]
Brummelte S, Grunau RE, Chau V, et al. Procedural pain andbrain development in premature newborns[J]. Ann Neurol, 2012, 71(3):385-396.
[5]
Grunau RE, Whitfield MF, Petrie-Thomas J, et al. Neonatal pain, parenting stress and interaction, in relation to cognitive and motor development at 8 and 18 months in preterm infants[J]. Pain, 2009, 143(1-2):138-146.
[6]
Doesburg SM, Chau CM, Cheung TP, et al. Neonatal painrelated stress, functional cortical activity and visual-perceptual abilities in school-age children born at extremely low gestation alage[J]. Pain, 2013, 154(10):1946-1952.
[7]
Walker SM. Biological and neurodevelopmental implications of neonatal pain[J]. Clin Perinatol, 2013, 40(3):471-491.
[8]
de Oliveira MV, de Jesus JA, Tristao RM. Psychophysical parameters of a multidimensional pain scale in newborns[J]. Physiol Meas, 2012, 33(1):39-49.
[9]
Johnston CC, Collinge JM, Henderson SJ, et al. A crosssectional survey of pain and pharmacological analgesia in Canadian neonatal intensive Cage units[J]. Clin J Pain, 1997, 13(4):308-312.
[10]
Bellù R, de Waal KA, Zanini R. Opioids for neonates receiving mechanical ventilation[J]. Cochrane Database Syst Rev, 2008, 23(1):CD004212.
[11]
Elserafy FA, Alsaedi SA, Louwrens J, et al. Oral sucrose and a pacifier for pain relief during simple procedures in preterm infants:a randomized controlled trial[J]. Ann Saudi Med, 2009, 29(3):184-188.
[12]
Anand KJ, Barton BA, McIntosh N, et al. Analgesia and sedation in preterm neonates who require ventilatory support:results from the NOPAIN trial. Neonatal Outcome and Prolonged Analgesia in Neonates[J]. Arch Pediatr Adolesc Med, 1999, 153(4):331-338.
[13]
Grunau RE, Haley DW, Whitfield ME, et al. Altered basal eortisol levels at 3, 6, 8 and 18 months in infants born at extremely low gestational age[J]. J Pediatr, 2007, 150(2):151-156.
[14]
Hall RW, Boyle E, Young T. Do ventilated neonates require pain management?[J]. Semin Perinatol, 2007, 31(5):289-297.
[15]
Stoppa F, PerroRa D, Tomasello C, et al. Low dose remifentanyl infusion for analgesia and sedation in ventilated newborns[J]. Minerva Anestesiol, 2004, 70(11):753-761.
Karlsen AP, Pedersen DM, Trautner S, et al. Safety of intranasal fentanyl in the out-of-hospital setting:a prospective observational study[J]. Ann Emerg Med, 2014, 63(6):699-703.