Pharmacological therapy for analgesia and sedation in the newborn. Issue 6 (20th October 2006)

• Record Type: Journal Article
• Authors: Anand, K J S; Hall, R W
• Is Part Of: Archives of disease in childhood. Volume 91:Issue 6(2006)
• Page Start: F448
• Page End: F453
• Publication Date: 2006-10-20
• Subjects: IVH, intraventricular haemorrhage -- NSAID, non-steroidal anti-inflammatory drug -- PVL, periventricular leucomalacia -- RCT, randomised controlled trial; Infants -- Diseases -- Periodicals; Newborn infants -- Diseases -- Periodicals; Fetus -- Diseases -- Periodicals; 618.920105
• DOI: 10.1136/adc.2005.082263
• Languages: English
• ISSNs: 1359-2998

Abstract

Abstract : Rapid advances have been made in the use of pharmacological analgesia and sedation for newborns requiring neonatal intensive care. Practical considerations for the use of systemic analgesics (opioids, non-steroidal anti-inflammatory agents, other drugs), local and topical anaesthetics, and sedative or anaesthetic agents (benzodiazepines, barbiturates, other drugs) are summarised using an evidence-based medicine approach, while avoiding mention of the underlying basic physiology or pharmacology. These developments have inspired more humane approaches to neonatal intensive care. Despite these advances, little is known about the clinical effectiveness, immediate toxicity, effects on special patient populations, or long-term effects after neonatal exposure to analgesics or sedatives. The desired or adverse effects of drug combinations, interactions with non-pharmacological interventions or use for specific conditions also remain unknown. Despite the huge gaps in our knowledge, preliminary evidence for the use of neonatal analgesia and sedation is available, but must be combined with a clear definition of clinical goals, continuous physiological monitoring, evaluation of side effects or tolerance, and consideration of long-term clinical outcomes.