Opioid analgesia for infants in the neonatal intensive care unit

Pharmacological analgesia in neonates undergoing cardiac surgery

“…Treatment with medication must be based on doses adjusted according to body weight, maturation, physiological development, and clinical condition of neonates (11) . Drugs may be continuous or intermittently administered.…”

“…Drugs may be continuous or intermittently administered. Continuous administration of opioids seems preferred over in bolus administration, since it reduces variation of serum concentration of the drug, thus decreasing toxicity associated with peaks of concentration (11) .…”

“…The use of opioids is recommended in neonates in intensive care undergoing large surgeries, mechanical pulmonary ventilation, placement of drains or venous catheters, and in diseases leading to pain, such as necrotizing enterocolitis (10) . However, must be carefully used and followed-up by continuous monitoring of vital data (11) in an intensive care environment.…”

“…This is a synthesized phenylpiperidine derivative opioid, 80 to 100 times more powerful than morphine (11) . It leads to analgesia by the link with µ receptors that are specific and are located in brain and spinal regions involved in the modulation and transmission of pain; it is extremely fat-soluble and spreads quickly to tissue making it easier for it to pass through the bloodbrain barrier (12) .…”

“…It leads to analgesia by the link with µ receptors that are specific and are located in brain and spinal regions involved in the modulation and transmission of pain; it is extremely fat-soluble and spreads quickly to tissue making it easier for it to pass through the bloodbrain barrier (12) . It presents quick onset, reaching peak between 5 to 15 minutes, and short half life, between 1 and 2 hours (11) .…”