Early awakening and extubation with remifentanil in ventilated premature neonates

Paediatric Anaesthesia
Yerkes Pereira e SilvaAna Cristina Simões e Silva

Abstract

Morphine is one of the most commonly used drugs for sedation and analgesia during mechanical ventilation, but its pharmacological profile has limitations, such as prolonged duration of action, especially in premature neonates. Because of its very short context-sensitive half-time, remifentanil has rapid onset and quickly decreases in plasma concentration after interrupting administration. The aim of the present study was to compare a continuous infusion of remifentanil and morphine during mechanical ventilation of premature neonates with respiratory distress syndrome (RDS). Twenty premature neonates (28-34 weeks) with RDS were randomized in a prospective double-blinded study to receive either a continuous infusion of morphine (n = 10) or remifentanil (n = 10) for mechanical ventilation. The length of time to awaken and extubate the neonate after interrupting opioid administration was recorded. We also recorded stress (COMFORT scale), pain response [Neonatal Infant Pain Scale (NIPS)], hemodynamic and ventilatory variables as well as adverse effects secondary to infusion of the specific opioid. After terminating infusion, the length of time required to awaken and extubate the neonates was 18.9- and 12.1-fold longer, respectively,...Continue Reading

References

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Citations

Jan 24, 2014·BioMed Research International·Ellen H M de KortSinno H P Simons
Jan 14, 2016·Journal of Anesthesia·Mineto Kamata, Joseph D Tobias
Aug 18, 2020·Journal of Pain Research·Hanna PopowiczWioletta A Mędrzycka-Dąbrowska
Mar 18, 2021·The Cochrane Database of Systematic Reviews·Roberto BellùMatteo Bruschettini

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