Effects of fentanyl administration on general and cerebral haemodynamics in sick newborn infants

Abstract

Despite the wide use of fentanyl for analgesia in newborns, concerns have been raised about potential haemodynamic side-effects. Since sick newborns may lose their cerebral blood flow autoregulation, a drug-induced haemodynamic instability could lead to brain injury. We assessed the effects of a 15-min infusion of fentanyl (3 micrograms/kg) on the general and cerebral haemodynamics in 15 newborns (median gestational age 29 weeks, 25th-75th percentile, range 28-31 weeks; birthweight 1170 g, range 955-1790 g). The heart rate and mean arterial blood pressure were continuously recorded. Mean cerebral blood flow velocity and pulsatility index were measured using pulsed Doppler ultrasound before, during and up to 60 min after the onset fentanyl administration. No significant modification of general or cerebral haemodynamics was observed. In conclusion, the infusion of 3 micrograms/kg of fentanyl did not lead to any deleterious effect on the general or cerebral haemodynamics in sick normovolaemic newborns.

Ventilation and Haemodynamic Indicators in Spontaneously Breathing Pigs under General Anaesthesia

“…For anaesthesia, we used a single dose of fentanyl. Our experimental and clinical experience confirms the information in the scientific literature that a single dose of fentanyl at 3.0 µg/kg minimally affects blood circulation (Hamon et al 1995). Dynamic pulmonary indices in spontaneously breathing animals were calculated based on the data measured after a transitional connection of experimental piglets to the respiratory device.…”

Cerebral Oxygenation during Different Treatment Strategies for a Patent Ductus Arteriosus

“…The degree and timing of change in cerebral rSO 2 may also be dependent on the extent and duration of decreased left ventricular cardiac function following surgical ligation [28,29] . The effect of sedation during surgery on rSO 2 may be minimal, although literature around alteration of cerebral hemodynamics after sedation in newborns is limited [30] .…”

Premedication for Nonemergency Endotracheal Intubation in the Neonate

“…Its impact on cerebral and systemic hemodynamics was studied with a short-term infusion in 15 preterm infants, and there were no significant changes in the systemic or cerebral perfusion or pressure. 28 Although fentanyl as a single agent in intubation has not been studied, a cohort study of 33 preterm and term infants intubated after a combination of atropine, fentanyl, and a paralytic agent showed that fentanyl had no significant adverse effects. 7 Remifentanil, another synthetic opiate, has a rapid onset of action and an ultrashort duration of action and has been shown to be a useful drug for neonatal intubation.…”