Dexmedetomidine versus intermittent morphine for sedation of neonates with encephalopathy undergoing therapeutic hypothermia.

Autor: Cosnahan AS; Department of Pharmacy, Bellevue Hospital Center, New York, NY, USA. annacosnahan2@gmail.com., Angert RM; Department of Pediatrics, NYU Grossman School of Medicine, New York, NY, USA., Jano E; Department of Pediatrics, NYU Grossman School of Medicine, New York, NY, USA., Wachtel EV; Department of Pediatrics, NYU Grossman School of Medicine, New York, NY, USA.; Department of Pediatrics, Bellevue Hospital Center, New York, NY, USA.
Jazyk: angličtina
Zdroj: Journal of perinatology : official journal of the California Perinatal Association [J Perinatol] 2021 Sep; Vol. 41 (9), pp. 2284-2291. Date of Electronic Publication: 2021 Mar 01.
DOI: 10.1038/s41372-021-00998-8
Abstrakt: Objective: In March 2019, the sedative in the therapeutic hypothermia protocol at Bellevue Hospital Center and NYU Langone Health changed from morphine to dexmedetomidine. This study evaluated the impact of this change on efficacy and safety parameters.
Study Design: This was a retrospective, observational cohort study including neonates with HIE undergoing therapeutic hypothermia (N = 70) at two regional perinatal medical centers.
Results: Baseline demographics, pain scores, hemodynamics, and time to enteral feeds were similar between dexmedetomidine (N = 34) and morphine (N = 36) patients. Dexmedetomidine patients received more breakthrough morphine (0.13 ± 0.13 vs 0.04 ± 0.09 mg/kg, p = 0.001), but less cumulative morphine (0.13 ± 0.13 vs 1.79 ± 0.23 mg/kg, p < 0.0001). Morphine patients on invasive ventilation required increased support (0 vs 31.58%, p = 0.02).
Conclusion: Dexmedetomidine is effective and safe for sedation and analgesia during therapeutic hypothermia. It reduced total opioid usage, with no increased incidence of adverse events.
(© 2021. The Author(s), under exclusive licence to Springer Nature America, Inc. part of Springer Nature.)
Databáze: MEDLINE
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