Canadian Neonatologist Practices Regarding Opioid Use in Ventilated and Spontaneously Breathing Infants Undergoing Medical Procedures

Abstract

Neonatologists frequently report using opioids to manage procedural pain, however, spontaneously breathing infants are less likely to receive them, and their use varies according to infant and procedure characteristics. These data point to the need to further investigate, in a more controlled design, the pharmacologic effects of opioids in this population to better guide clinicians about their optimal use.

Diagnostic practices and disease surveillance in Canadian children with congenital central hypoventilation syndrome

“…There were several limitations to our study. First, the overall survey response rate was lower than other published Canadian surveys of pediatric subspecialists but not dissimilar from other recently published pediatric Internet-based survey results (11)(12)(13)(14). The lower response rate may be related to the rarity of the disease.…”

Implementation of a neonatal pain management module in the computerized physician order entry system

“…Although the message that relieving and preventing PAD in newborns has been widely disseminated to all concerned medical staff, PAD management remains inadequate [7,8]. In 2006, a rigorous analysis of the literature suggested that these practices could be improved by establishing precise objectives, including the systematic evaluation of PAD and the development and formalization of protocols for its management [9,10].…”

Pain Panacea for Opiophobia in Infants?

“…Previous studies reveal a widespread reluctance to treat pain with adequately dosed opioids, particularly in nonventilated infants. 19,20 Wide variability in clinical practices continues at present, mostly driven by personal preferences or institutional practices, with up to 100-fold differences in initial opioid doses, average daily doses, cumulative doses, or peak infusion rates. 21 Based on morphine pharmacokinetics in this age group, Ceelie et al 3 followed a strict analgesic protocol for both groups of infants.…”