Randomised controlled trial of low dose fentanyl infusion in preterm infants with hyaline membrane disease
Pain Study Group and Neonatal Intensive Care Unit,
Department of Paediatrics, University of Padova, Italy
Correspondence to: Dr Paola Lago, Pain Study Group, Department of Paediatrics, University of Padova, Via Giustiniani 3, 35128 Padova, Italy. Email: paolal{at}child.pedi.unipd.it
Accepted 22 April 1998
Aim
To evaluate the effects of low dose
fentanyl infusion analgesia on behavioural and neuroendocrine stress
response and short term outcome in premature infants ventilated for
hyaline membrane disease.
METHODSTwenty seven ventilated preterm infants
were randomly assigned to receive a mean fentanyl infusion of 1.1 (0.08 SE) µg/kg/h for 75 (5) hours, and 28 untreated infants were
considered a control group. A behavioural sedation score was used to
assess the infants' behaviour. Urinary metanephrine and the
normetanephrine:creatinine molar ratio were determined at 0, 24, 48 and
72 hours. Outcome data and ventilatory indexes were recorded for each infant.
RESULTSThe fentanyl group showed significantly
lower behavioural stress scores and O2 desaturations than
controls and lower urinary concentrations of metanephrine and
normetanephrine at 24, 48, 72 hours. The two groups showed no
significant difference in ventilatory variables or short term outcome.
CONCLUSIONSA short course of low dose fentanyl
infusion reduces behavioural sedation scores, O2
desaturations and neuroendocrine stress response in preterm ventilated infants.
© 1998 by Archives of Disease in Childhood
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