Pharmacological analgesia in neonates undergoing cardiac surgery

Bueno, Mariana; Kimura, Amélia Fumiko; Pimenta, Cibele Andrucioli de Mattos

doi:10.1590/s0104-11692008000400012

Cited by 8 publications

(10 citation statements)

References 13 publications

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“…At present, the consensus reached among Dutch pediatricians and pharmacists is that the risks of dipyrone outweighed any possible analgesic benefit. This practice is in contrast to the practice in other countries, where dipyrone is even given to neonates …”

Section: Introductionmentioning

confidence: 99%

“…This practice is in contrast to the practice in other countries, where dipyrone is even given to neonates. 15 In conclusion, there are many uncertainties about the use of dipyrone, especially in children. Given the potential added value of dipyrone in the treatment of acute pain, a balanced risk-benefit analysis is needed to provide better guidance to physicians.…”

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confidence: 99%

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The use of dipyrone (metamizol) as an analgesic in children: What is the evidence? A review

Leeuw

Dirckx

Candel

et al. 2017

Pediatric Anesthesia

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Dipyrone has analgesic, spasmolytic, and antipyretic effects and is used to treat pain. Due to a possible risk of agranulocytosis with the use of dipyrone, it has been banned in a number of countries. The most commonly used data for the use of dipyrone are related to adults. Information relating to the use of dipyrone in children is scarce. Given the potential added value of dipyrone in the treatment of pain, a review of the literature was conducted to obtain more insight into the analgesic efficacy of dipyrone in children as well as the safety of dipyrone in terms of adverse events. A literature search was done for original articles (in English, German, or Spanish language) which met the following criteria: the use of dipyrone for pain and children up to the age of 17 years old. All titles and abstracts retrieved were reviewed, independently, by two of the authors, for their suitability for inclusion. The references of the selected articles were also checked for additional relevant papers. The publications were categorized into case reports, observational studies, or randomized controlled trials. To assess the methodological quality of the studies, the Jadad score was used. In the limited available data, the analgesic efficacy of intravenous dipyrone appears similar to that of intravenous paracetamol. Evidence is lacking to support the claim that dipyrone is equivalent or even superior to Non-Steroid-Anti-Inflammatory-Drugs in pediatric pain. While the absolute risk of agranulocytosis with dipyrone in children, based on available literature, cannot be determined, case reports suggest that this risk is not negligible.

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Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

The use of dipyrone (metamizol) as an analgesic in children: What is the evidence? A review

Leeuw

Dirckx

Candel

et al. 2017

Pediatric Anesthesia

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show abstract

“…However, pain was not evaluated by scoring with a validated pain scale, because the hypothesis was established after recruitment of the sample; instead, the attendants used a combination of physiological and behavioral changes to estimate the pain in patients [10] , which we recognize as a study limitation. This limitation appears to be related to clinical practice in NICUs, where the majority of patients did not receive pain assessment with a scale, as was reported in a study of 30 NICUs where 16.7% of the neonates received a pain assessment with a scale [48] , while painful procedures such as tracheal intubation and cardiac surgery were assessed with pain scales in 58 and 56.7% of the neonates, respectively [41,49] . Another limitation was that DHA-containing oil had higher saturated fatty acids: lauric, myristic and palmitic, but lower linoleic and oleic acids compared with SO administered to the control group.…”

Section: Discussionmentioning

confidence: 99%

Enteral Docosahexaenoic Acid Reduces Analgesic Administration in Neonates Undergoing Cardiovascular Surgery

et al. 2016

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Background: Neonates undergoing surgery require analgesic medication to ameliorate acute pain. These medications produce negative side effects. Docosahexaenoic acid (DHA) has an antinociceptive effect in animals, but this has not been evaluated in human neonates. We evaluated the DHA effect on cumulative dose and duration of analgesics administered to neonates undergoing cardiovascular surgery. Methods: A secondary analysis was performed with data from a clinical trial, in which enteral DHA was administered perioperatively compared with sunflower oil (SO). Present study assessed the antinociceptive effect of DHA by measuring the cumulative dose and duration of analgesics administered during postoperative stay in a neonatal intensive care unit. Multivariate linear regression models were performed. Results: Seventeen neonates received DHA and 18 received SO in the control group. Compared with the control group, the DHA group received lower cumulative dose (14.6 ± 2.2 vs. 25.2 ± 4.8 μg/kg, p = 0.029) and shorter duration of buprenorphine (2 days (1-8) vs. 4.5 days (1-12); p = 0.053). After adjusting for confounders, the DHA group received significantly lesser buprenorphine (β = -27 μg/kg, p = 0.028; R² model = 0.90) for shorter duration (β = -9 days, p = 0.003; R² model = 0.94). No differences in fentanyl or ketorolac were detected. Conclusions: Buprenorphine administration was reduced in neonates who received DHA, suggesting that DHA likely has analgesic effects.

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“…In one neonatal unit in Sao Paulo (19) , postoperative pain with recommendation for painkiller (score >5 on the scale Crying Requires Increased Oxygen Administration, Increased Vital Signs, Expression, Sleeplessness) was verified in 50.0% of NBs in the immediate postoperative period, 40.0% of NBs in the first post-operative and 27.0% of NBs in the second postoperative period. The results of this study showed the need for systematic assessment of pain in the postoperative period, and use of pharmacological and non-pharmacological interventions for treatment of neonatal pain in this period (19) . It also found that the participants had a knowledge deficit regarding the use of non-pharmacological measures effective in relieving acute pain in NBs, especially among nursing aides/technicians and physical therapists.…”

Section: Discussionmentioning

confidence: 99%

Conhecimento dos profissionais de saúde na avaliação e tratamento da dor neonatal

et al. 2016

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Pharmacological analgesia in neonates undergoing cardiac surgery

Cited by 8 publications

References 13 publications

The use of dipyrone (metamizol) as an analgesic in children: What is the evidence? A review

The use of dipyrone (metamizol) as an analgesic in children: What is the evidence? A review

Enteral Docosahexaenoic Acid Reduces Analgesic Administration in Neonates Undergoing Cardiovascular Surgery

Conhecimento dos profissionais de saúde na avaliação e tratamento da dor neonatal

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