Sedatives for opiate withdrawal in newborn infants

Osborn, DA; He, Jianming; Mj, Cole

doi:10.1002/14651858.cd002053

Cited by 25 publications

(28 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A recent retrospective review25 concluded that the duration of treatment required is shorter with chlorpromazine than morphine; however, compared with opiates, infants treated with chlorpromazine appear more likely to develop seizures 26. A Cochrane review concluded there was no role for chlorpromazine in NAS due to a lack of randomised studies 27. Similarly, chloral hydrate which exerts a sedative effect through the metabolite trichloroethanol is utilised in approximately 18% of units despite a lack of evidence to support such a policy.…”

Section: Discussionmentioning

confidence: 99%

Management of neonatal abstinence syndrome: a national survey and review of practice

O’Grady

Hopewell

White

2009

Archives of Disease in Childhood - Fetal and Neonatal Edition

102

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

Management of neonatal abstinence syndrome: a national survey and review of practice

O’Grady

Hopewell

White

2009

Archives of Disease in Childhood - Fetal and Neonatal Edition

102

View full text Add to dashboard Cite

show abstract

“…9 10 Studies to date can be criticised on their lack of standardisation of outcome measures, problems with randomisation, and failure to use a pre-evaluated scoring system to allow standardisation of the start of treatment, dosage alterations, and termination of pharmaceutical treatment. [11][12][13] The aim of this study was to compare the efficacy of initial treatment with an opiate versus phenobarbitone for infants with NAS caused by opiate withdrawal. The total duration of pharmaceutical treatment required to achieve symptom resolution was predefined as the primary study end point, and the requirement for higher intensity nursing in the SCBU or the need for an additional second line treatment as secondary end points.…”

mentioning

confidence: 99%

A randomised controlled trial of morphine versus phenobarbitone for neonatal abstinence syndrome

Jackson

2004

Archives of Disease in Childhood - Fetal and Neonatal Edition

View full text Add to dashboard Cite

Background: The incidence of neonatal abstinence syndrome (NAS) has increased 10-fold over the last decade in Glasgow. In the Princess Royal Maternity Hospital, it now accounts for 17% of special care baby unit (SCBU) admissions. Objective: To compare opiate replacement therapy (morphine sulphate) with the present standard treatment (phenobarbitone) for management of NAS. The primary study end point was duration of pharmaceutical treatment. Secondary end points were the requirement for additional drugs and the requirement for SCBU admission. Design: Double blind, randomised controlled clinical trial. Methods: Differential diagnoses were excluded, and two consecutive Lipsitz scores . 4 defined NAS requiring treatment. Infants were randomised to receive morphine sulphate or phenobarbitone. Treatments were identical in appearance, odour, and volume. Increments, decrements, and discontinuation of treatments were protocol driven. Results: Seventy five infants participated. All mothers received opiate replacement therapy (methadone) during pregnancy and most used other drugs (n = 62, 83%). No significant difference in maternal drug use patterns was observed between treatment groups. Median treatment duration was four days shorter with opiate replacement (8 v 12 days, Mann-Whitney U test, p = 0.02). Phenobarbitone treated infants tended to require second line treatment (47% v 35%, x 2 test, p = 0.11) and SCBU admission (62% v 30%, x 2 test, p = 0.04) more often. Conclusions: Opiate replacement therapy appears to be superior for management of symptomatic NAS when maternal opiate use is prevalent. The shorter treatment duration and lower requirement for higher intensity nursing may have significant cost implications. Tailoring NAS treatment to local maternal drug use may result in similar benefits.

show abstract

“…The two most commonly used adjunctive medications are phenobarbital and clonidine. Several studies yielded contradictory results in evaluating the efficacy of adjunctive treatment with phenobarbital and clonidine; however, a 2010 Cochrane Review of six studies concluded that addition of phenobarbital or clonidine may reduce duration of treatment for NAS 63. These medications have also been compared directly to one another (in combination with morphine) 64.…”

Section: Neonatal Managementmentioning

confidence: 99%

The opioid epidemic and neonatal abstinence syndrome in the USA: a review of the continuum of care

Pryor

Maalouf

Krans

et al. 2017

Arch Dis Child Fetal Neonatal Ed

View full text Add to dashboard Cite

As the prescription opioid epidemic grew in the USA, its impact extended to pregnant women and their infants. This review summarises how increasing rates of neonatal abstinence syndrome resulted in a need to improve care to pregnant women and opioid-exposed infants. We discuss the variations in care delivery with particular emphasis on screening at-risk mothers, scoring systems for neonatal drug withdrawal, type and duration of pharmacotherapy, and discharge safety.

show abstract

Sedatives for opiate withdrawal in newborn infants

Cited by 25 publications

References 35 publications

Management of neonatal abstinence syndrome: a national survey and review of practice

Management of neonatal abstinence syndrome: a national survey and review of practice

A randomised controlled trial of morphine versus phenobarbitone for neonatal abstinence syndrome

The opioid epidemic and neonatal abstinence syndrome in the USA: a review of the continuum of care

Contact Info

Product

Resources

About