Background
Sedative-analgesics are often given to newborn infants and are known to affect
many components of the autonomic nervous system. While morphine is most frequently used,
α-2 adrenergic receptor agonists are being increasingly used in this population.
Alpha-2 adrenergic receptors agonists also have anti-shivering properties which may make
it a desirable drug to give to infants undergoing therapeutic hypothermia. The aim of
this study was to systematically compare two different classes of sedative-analgesics,
morphine, a μ-opioid receptor agonist, and clonidine an α-2 adrenergic
receptor agonist on breathing, metabolism and core body temperature (CBT) in neonatal
rodents.
Methods
Breathing parameters, oxygen consumption (VO2) and carbon dioxide
production (VCO2), were measured prior to, 10 and 90 minutes after
intraperitoneal (IP) administration of morphine (2, 10 or 20mg/kg), clonidine (40, 200
or 400 μg/kg), or saline in Sprague-Dawley rat pups at postnatal day 7 (p7)
while continuously monitoring CBT.
Results
Morphine reduced the respiratory rate, VO2 and VCO2
greater than clonidine at all dosages used (p<0.05, morphine vs. clonidine, for all
metabolic and respiratory parameters). Furthermore, morphine induced prolonged
respiratory pauses, which were not observed in animals treated with clonidine or saline.
Morphine caused hypothermia which was dose dependent, while clonidine stabilized CBT in
comparison to saline treated animals (p<0.0001).
Conclusion
In the newborn rat, morphine causes profound respiratory depression and
hypothermia while clonidine causes minimal respiratory depression and stabilizes CBT.
All together, we suggest that clonidine promotes autonomic stability and may be a
desirable agent to use in infants being treated with therapeutic hypothermia.