Remifentanil for percutaneous intravenous central catheter placement in preterm infant: a randomized controlled trial

Lago, Paola; Tiozzo, Caterina; Boccuzzo, Giovanna; Allegro, Antonella; Zacchello, Franco

doi:10.1111/j.1460-9592.2008.02636.x

Cited by 45 publications

(34 citation statements)

References 27 publications

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“…These results corroborate previous studies that evaluated interventions for sedation and analgesia during PICC insertion in neonates (7,(14)(15)19) . There are probably other factors in addition to movement of the extremities, such as the conditions of the venous system and professional experience, which have some relation to the degree of ease of performing the procedure and the duration of procedure.…”

Section: Discussionsupporting

confidence: 82%

“…The results showed that pain scores were lower in the group that received remifentanil 0.03 mcg/kg/min and 0.3 mL of 12% sucrose orally and nonnutritive sucking in comparison with the control group, which received only 0.3 mL of 12% sucrose orally and non-nutritive sucking two minutes before the procedure during skin preparation. It was concluded that low-dose remifentanil (0.03 mcg/kg/min) has a measurable, synergic analgesic effect in combination with 12% sucrose and nonnutritive sucking in preterm newborns, but does not make PICC insertion easier or quicker (14) .…”

Section: Discussionmentioning

confidence: 99%

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Analgesia e sedação durante a instalação do cateter central de inserção periférica em neonatos

Costa

Bueno

Oliva

et al. 2013

Rev. esc. enferm. USP

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Objetivou-se caracterizar as estratégias de analgesia e sedação em neonatos submetidos à instalação do cateter central de inserção periférica (CCIP) e relacioná-las ao número de punções venosas, duração do procedimento e posicionamento da ponta do cateter. Estudo transversal com coleta prospectiva de dados, realizado em uma unidade de cuidados intensivos neonatais de um hospital privado na cidade de São Paulo, no período de 31 de agosto de 2010 a 01 de julho de 2011, em que foram avaliadas 254 inserções do CCIP. A adoção de estratégias analgésicas ou sedativas ocorreu em 88 (34,6%) instalações do cateter e não esteve relacionada ao número de punções venosas, duração do procedimento ou posicionamento da ponta do cateter. As estratégias mais frequentes foram a administração endovenosa de midazolam em 47 (18,5%) e fentanil em 19 (7,3%) inserções do cateter. Recomenda-se maior adoção de estratégias analgésicas antes, durante e após o procedimento.

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Section: Discussionsupporting

confidence: 82%

Section: Discussionmentioning

confidence: 99%

Analgesia e sedação durante a instalação do cateter central de inserção periférica em neonatos

Costa

Bueno

Oliva

et al. 2013

Rev. esc. enferm. USP

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“…94 Remifentanil, a shorter-acting fentanyl derivative, may be an alternative for short-term procedures and surgeries because it is not cleared by liver metabolism, but there are no studies examining its long-term effects. 95,96 Benzodiazepines, most commonly midazolam, are frequently used in the NICU for sedation. However, because there is evidence of only minor additional analgesic effect, they may not provide much benefit.…”

Section: Opioids Benzodiazepines and Other Drugsmentioning

confidence: 99%

Prevention and Management of Procedural Pain in the Neonate: An Update

Keels¹,

Sethna²,

Watterberg³

et al. 2016

Pediatrics

333

171

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The prevention of pain in neonates should be the goal of all pediatricians and health care professionals who work with neonates, not only because it is ethical but also because repeated painful exposures have the potential for deleterious consequences. Neonates at greatest risk of neurodevelopmental impairment as a result of preterm birth (ie, the smallest and sickest) are also those most likely to be exposed to the greatest number of painful stimuli in the NICU. Although there are major gaps in knowledge regarding the most effective way to prevent and relieve pain in neonates, proven and safe therapies are currently underused for routine minor, yet painful procedures. Therefore, every health care facility caring for neonates should implement (1) a pain-prevention program that includes strategies for minimizing the number of painful procedures performed and (2) a pain assessment and management plan that includes routine assessment of pain, pharmacologic and nonpharmacologic therapies for the prevention of pain associated with routine minor procedures, and measures for minimizing pain associated with surgery and other major procedures.

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“…Remifentanil decreased pain for PICC insertion (169) Thoracic rigidity requiring muscle blocker injection (alfentanil 20 g/kg) (167). Same time to complete the maneuver and procedure time as placebo (169) Acetaminophen Ն37 wks GA No effect for heel lance (170) Good hepatic tolerance (149) Ketamine Ineffective for tracheal suctioning (125) No cerebral hemodynamic adverse effect (5 mg/kg) (124) Repetitive painful stimuli may persistently alter pain processing in humans (171), and epidemiologic studies have revealed an association between peri-and neonatal complications and behavioral/emotional problems in childhood, anxiety/ depression, and even suicidal tendencies (172,173).…”

Section: Remaining Urgent Questions and Perspectivesmentioning

confidence: 99%

Use of Analgesic and Sedative Drugs in the NICU: Integrating Clinical Trials and Laboratory Data

et al. 2010

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Recent advances in neonatal intensive care include and are partly attributable to growing attention for comfort and pain control in the term and preterm infant requiring intensive care. Limitation of painful procedures is certainly possible, but most critically ill infants require unavoidable painful or stressful procedures such as intubation, mechanical ventilation, or catheterization. Many analgesics (opioids and nonsteroidal anti-inflammatory drugs) and sedatives (benzodiazepines and other anesthetic agents) are available but their use varies considerably among units. This review summarizes current experimental knowledge on the effects of sedative and analgesic drugs on brain development and reviews clinical evidence that speaks for or against the use of common analgesic and sedative drugs in the NICU but avoids any discussion of anesthesia during surgery. Risk/benefit ratios of intermittent boluses or continuous infusions for the commonly used sedative and analgesic agents are discussed in the light of clinical and experimental studies. The limitations of extrapolating experimental results from animals to humans must be considered while making practical recommendations based on the currently available evidence.

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Remifentanil for percutaneous intravenous central catheter placement in preterm infant: a randomized controlled trial

Abstract: Low-dose remifentanil has a measurable, synergic analgesic effect in combination with 12% sucrose and non-nutritive sucking, but does not make PICC easier or quicker.

Cited by 45 publications

References 27 publications

Analgesia e sedação durante a instalação do cateter central de inserção periférica em neonatos

Analgesia e sedação durante a instalação do cateter central de inserção periférica em neonatos

Prevention and Management of Procedural Pain in the Neonate: An Update

Use of Analgesic and Sedative Drugs in the NICU: Integrating Clinical Trials and Laboratory Data

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