Prise en charge du syndrome de sevrage du nouveau-né de mère toxicomane aux opiacés : enquête française et européenne

Hospital morphine preparation for abstinence syndrome in newborns exposed to buprenorphine or methadone

“…In our buprenorphine group doses were higher with six divided doses being used to achieve between 0.012 and 0.838 mg/kg/day, i.e., 0.010-0.741 mg/ kg/day of morphine base. The survey of Micard and Brion [23] also noted that the duration of morphine treatment was longer than 15 days in 60% of French centers. This is comparable with the findings of Lejeune et al who reported that mean treatment duration was 16.9 days with a range from 2 to 69 days [22].…”

“…In our study, we found that first-peak Lipsitz scores occurred later in the buprenorphine group than in the methadone group. In 2003, Micard and Brion [23] performed a questionnaire survey of European Society of Clinical Pharmacy members to gain insight into NAS management in paediatric units in Europe. Findings showed that morphine sulfate solution was commonly administered in six divided doses to achieve 0.24 mg/kg/day, i.e., 0.18 mg/kg/day of morphine base [23].…”

“…In 2003, Micard and Brion [23] performed a questionnaire survey of European Society of Clinical Pharmacy members to gain insight into NAS management in paediatric units in Europe. Findings showed that morphine sulfate solution was commonly administered in six divided doses to achieve 0.24 mg/kg/day, i.e., 0.18 mg/kg/day of morphine base [23]. In France, morphine hydrochloride solution is widely used in four to eight divided doses to achieve 0.5-1 mg/kg/day, i.e., 0.38-0.76 mg/kg/day of morphine base [23].…”

“…Findings showed that morphine sulfate solution was commonly administered in six divided doses to achieve 0.24 mg/kg/day, i.e., 0.18 mg/kg/day of morphine base [23]. In France, morphine hydrochloride solution is widely used in four to eight divided doses to achieve 0.5-1 mg/kg/day, i.e., 0.38-0.76 mg/kg/day of morphine base [23]. Maximum morphine doses in the two groups studied here were not higher than those reported by Micard and Brion [23] in France: 0.705 ± 0.210 mg/kg/ day, i.e, 0.624 ± 0.185 mg/kg/day of morphine base (methadone group) and 0.440 ± 0.139 mg/kg/day, i.e., 0.389 ± 0.123 mg/kg/day of morphine base (buprenorphine group).…”

“…In France, morphine hydrochloride solution is widely used in four to eight divided doses to achieve 0.5-1 mg/kg/day, i.e., 0.38-0.76 mg/kg/day of morphine base [23]. Maximum morphine doses in the two groups studied here were not higher than those reported by Micard and Brion [23] in France: 0.705 ± 0.210 mg/kg/ day, i.e, 0.624 ± 0.185 mg/kg/day of morphine base (methadone group) and 0.440 ± 0.139 mg/kg/day, i.e., 0.389 ± 0.123 mg/kg/day of morphine base (buprenorphine group). Our findings showed also that mean morphine doses in the methadone group were 1.7 times higher and that the starting dose for morphine treatment should be 0.5 mg/kg/ day in methadone-exposed infants.…”