Document Detail


Comparison of sufentanil versus fentanyl in ventilated term neonates.
MedLine Citation:
PMID:  19731193     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Increasingly frequent applications of opioid analgesics in neonatal intensive care require the evaluation of efficacy and side effects. PATIENTS: Mechanically ventilated term neonates were consecutively enrolled. METHODS: In a double-blind randomized trial 20 newborns received a continuous intravenous infusion of fentanyl (n=10) or sufentanil (n=10) in an assumed equipotent dose of 7:1. The analgesic dose was individually adjusted according to sedation scores. The period between cessation of analgesic medication and successful extubation (weaning time), adverse drug effects and urinary cortisol concentrations were evaluated. RESULTS: No significant difference of weaning time was seen between fentanyl and sufentanil group (mean weaning time (+/-SD) of fentanyl group 520+/-381 min, median 380 min; sufentanil group 585+/-531 min, median 405 min, p=0.78, 2-tailed U-Test, Mann and Whitney). The mean opioid dose resulted in a 10:1 ratio (fentanyl 4.11 microg/(kg x h) vs sufentanil 0.41 microg/(kg x h)). We found no marked differences in sedation levels, blood pressure, heart rate, oxygenation index, co-medication or urinary cortisol levels. In both groups similar adverse effects were assessed including respiratory depression, mild withdrawal symptoms or decrease of gastrointestinal motility. CONCLUSION: In our study sufentanil did not reduce the weaning period in ventilated term neonates when compared to fentanyl. The equipotent dose ratio for fentanyl/sufentanil was 10:1. According to sedation scores both substances provided effective pain and stress protection.
Authors:
B Schmidt; C Adelmann; H St?tzer; L Welzing; C H?nseler; A Kribs; B Roth
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Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2009-09-03
Journal Detail:
Title:  Klinische P?diatrie     Volume:  222     ISSN:  1439-3824     ISO Abbreviation:  Klin Padiatr     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-03-22     Completed Date:  2010-06-30     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0326144     Medline TA:  Klin Padiatr     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  62-6     Citation Subset:  IM    
Copyright Information:
(c) Georg Thieme Verlag KG Stuttgart-New York.
Affiliation:
Department of Neonatology and Pediatric Intensive Care Medicine, Children's Hospital, University of Cologne.
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MeSH Terms
Descriptor/Qualifier:
Anesthesia, Intravenous*
Anesthetics, Intravenous* / pharmacokinetics
Arousal / drug effects
Dose-Response Relationship, Drug
Double-Blind Method
Fentanyl* / pharmacokinetics
Half-Life
Humans
Infant, Newborn
Intermittent Positive-Pressure Breathing
Intermittent Positive-Pressure Ventilation*
Oxygen Inhalation Therapy
Pain Measurement / drug effects
Positive-Pressure Respiration
Prospective Studies
Respiratory Distress Syndrome, Newborn / therapy*
Sufentanil* / pharmacokinetics
Ventilator Weaning
Chemical
Reg. No./Substance:
0/Anesthetics, Intravenous; 437-38-7/Fentanyl; 56030-54-7/Sufentanil

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