Document Detail

Infant pupillary response to methadone administration during treatment for neonatal abstinence syndrome: a feasibility study.
MedLine Citation:
PMID:  22682657     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Pupil diameter is a frequently assessed objective index of the pharmacodynamic effects of opioids in adults, but to our knowledge has never been examined in infants. Such a measure could improve assessment and treatment of neonates exposed to opioids in utero. The present study examined changes in pupil diameter after opioid administration in opioid-exposed infants who required pharmacological treatment for neonatal abstinence syndrome (NAS) to test the feasibility of using pupil diameter as a measure of opioid effects in these infants.
METHODS: Ten infants (2-7 days old) receiving methadone (0.4-0.5 mg every 12 h) for the treatment of NAS participated. A picture of one of each infant's eyes was taken under controlled illumination conditions with a standard digital camera just prior to dosing and 0-1, 2-4, 5-7, and 8-10h after dosing. The diameters of the pupil and iris were measured and relative pupil diameter (pupil diameter expressed as a percentage of iris diameter) was analyzed.
RESULTS: Mean (±SE) relative pupil diameter decreased significantly after dosing from 41±2% to 29±2%. After dosing, a significant increasing linear trend was observed over time, with values of 29±2%, 33±3%, 38±3%, and 41±3% at 0-1, 2-4, 5-7, and 8-10h after dosing.
CONCLUSIONS: Infant pupils respond to opioid administration in the same sensitive, orderly manner as is commonly observed in adults. Pupil diameter appears to be an objective, sensitive measure of neonatal response to opioids that may be a useful complement to, or perhaps at times a replacement for, observer-rated scale scores.
Sarah H Heil; Diann E Gaalema; Anne M Johnston; Stacey C Sigmon; Gary J Badger; Stephen T Higgins
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural     Date:  2012-06-08
Journal Detail:
Title:  Drug and alcohol dependence     Volume:  126     ISSN:  1879-0046     ISO Abbreviation:  Drug Alcohol Depend     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-10-22     Completed Date:  2013-04-08     Revised Date:  2013-11-06    
Medline Journal Info:
Nlm Unique ID:  7513587     Medline TA:  Drug Alcohol Depend     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  268-71     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.
Department of Psychiatry, University of Vermont, USA.
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MeSH Terms
Analysis of Variance
Dose-Response Relationship, Drug
Feasibility Studies
Image Interpretation, Computer-Assisted
Infant, Newborn
Methadone / pharmacology*,  therapeutic use*
Narcotics / pharmacology*,  therapeutic use*
Neonatal Abstinence Syndrome / drug therapy*,  physiopathology
Reflex, Pupillary / drug effects*
Grant Support
Reg. No./Substance:
0/Narcotics; 76-99-3/Methadone

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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