Morphine-related apnoea in CPAP-treated preterm neonates
Background: Morphine can be used to treat pain in preterm neonates with CPAP because of its analgetic potency; however, it is known to induce apnoea. Aim: To evaluate this risk of apnoea. Methods: We retrospectively analysed 91 preterm neonates with CPAP who received morphine intravenously. The inci...
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| Veröffentlicht in: | Acta Paediatrica 2006-09, Vol.95 (9), p.1087-1092 |
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| creator | Enders, Jan Gebauer, Corinna Pulzer, Ferdinand Robel-Tillig, Eva Knüpfer, Matthias |
| description | Background: Morphine can be used to treat pain in preterm neonates with CPAP because of its analgetic potency; however, it is known to induce apnoea. Aim: To evaluate this risk of apnoea. Methods: We retrospectively analysed 91 preterm neonates with CPAP who received morphine intravenously. The incidence of apnoea 4 h before and after morphine administration was compared. The data were analysed for three dosage groups ( 0.03 mg/kg (0.3±0.67 vs 1.5±2.5 apnoea). Interestingly, we found a significantly delayed increase in apnoea in the fourth hour.
Conclusion: Morphine in preterm infants with CPAP is not widely accepted practice until further randomized studies evaluate efficacy and safety. Morphine in a low dosage (≤0.03 mg/kg) did not significantly increase the apnoea rate in CPAP‐treated preterm infants. For clinical work, it is very important to note that morphine‐related apnoea may appear with a delay of approximately 4 h. |
| doi_str_mv | 10.1080/08035250600577871 |
| format | Article |
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Conclusion: Morphine in preterm infants with CPAP is not widely accepted practice until further randomized studies evaluate efficacy and safety. Morphine in a low dosage (≤0.03 mg/kg) did not significantly increase the apnoea rate in CPAP‐treated preterm infants. For clinical work, it is very important to note that morphine‐related apnoea may appear with a delay of approximately 4 h.</description><identifier>ISSN: 0803-5253</identifier><identifier>EISSN: 1651-2227</identifier><identifier>DOI: 10.1080/08035250600577871</identifier><identifier>PMID: 16938755</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Publishing Ltd</publisher><subject>Analgesia ; Analgesics, Opioid - administration & dosage ; Analgesics, Opioid - adverse effects ; Apnea - chemically induced ; apnoea ; Biological and medical sciences ; Continuous Positive Airway Pressure - adverse effects ; General aspects ; Humans ; Infant, Newborn ; Infant, Premature ; Infant, Premature, Diseases - chemically induced ; Medical sciences ; morphine ; Morphine - administration & dosage ; Morphine - adverse effects ; pain ; preterm infants ; Retrospective Studies ; Risk Factors ; Time Factors</subject><ispartof>Acta Paediatrica, 2006-09, Vol.95 (9), p.1087-1092</ispartof><rights>2006 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4147-afffd11f4c6948234f897eb7a3d5a72f3c41182067f881fabb9f0f8c37fef8b53</citedby><cites>FETCH-LOGICAL-c4147-afffd11f4c6948234f897eb7a3d5a72f3c41182067f881fabb9f0f8c37fef8b53</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1080%2F08035250600577871$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1080%2F08035250600577871$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27923,27924,45573,45574</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=18099526$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/16938755$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Enders, Jan</creatorcontrib><creatorcontrib>Gebauer, Corinna</creatorcontrib><creatorcontrib>Pulzer, Ferdinand</creatorcontrib><creatorcontrib>Robel-Tillig, Eva</creatorcontrib><creatorcontrib>Knüpfer, Matthias</creatorcontrib><title>Morphine-related apnoea in CPAP-treated preterm neonates</title><title>Acta Paediatrica</title><addtitle>Acta Paediatr</addtitle><description>Background: Morphine can be used to treat pain in preterm neonates with CPAP because of its analgetic potency; however, it is known to induce apnoea. Aim: To evaluate this risk of apnoea. Methods: We retrospectively analysed 91 preterm neonates with CPAP who received morphine intravenously. The incidence of apnoea 4 h before and after morphine administration was compared. The data were analysed for three dosage groups (<0.01, 0.01–0.03 and 0.03 mg/kg) and according to the incidence of apnoea before morphine application. Results: In the whole group (gestational age 29.1±2.9 wk, morphine dosage 0.017±0.01 mg/kg) we did not find differences in apnoea before and after morphine (0.9±1.8 vs 1.1±1.8 apnoea). The only significant increase in apnoea was seen in the subgroup of patients receiving > 0.03 mg/kg (0.3±0.67 vs 1.5±2.5 apnoea). Interestingly, we found a significantly delayed increase in apnoea in the fourth hour.
Conclusion: Morphine in preterm infants with CPAP is not widely accepted practice until further randomized studies evaluate efficacy and safety. Morphine in a low dosage (≤0.03 mg/kg) did not significantly increase the apnoea rate in CPAP‐treated preterm infants. For clinical work, it is very important to note that morphine‐related apnoea may appear with a delay of approximately 4 h.</description><subject>Analgesia</subject><subject>Analgesics, Opioid - administration & dosage</subject><subject>Analgesics, Opioid - adverse effects</subject><subject>Apnea - chemically induced</subject><subject>apnoea</subject><subject>Biological and medical sciences</subject><subject>Continuous Positive Airway Pressure - adverse effects</subject><subject>General aspects</subject><subject>Humans</subject><subject>Infant, Newborn</subject><subject>Infant, Premature</subject><subject>Infant, Premature, Diseases - chemically induced</subject><subject>Medical sciences</subject><subject>morphine</subject><subject>Morphine - administration & dosage</subject><subject>Morphine - adverse effects</subject><subject>pain</subject><subject>preterm infants</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Time Factors</subject><issn>0803-5253</issn><issn>1651-2227</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2006</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkDtPwzAQgC0EoqXwA1hQFkaDH_EjY4hKARXoACqb5SS2CKRJZAdB_z0uqejAwHA66e777nQHwClGFxhJdBmCMsIQR4gJIQXeA2PMGYaEELEPxps-DAAdgSPv3xAiNIn5IRhhnlApGBsDed-67rVqDHSm1r0pI901rdFR1UTZIl3A3pmfcudMb9wqakzbhII_BgdW196cbPMEPF9Pn7IbOH-c3WbpHBYxjgXU1toSYxsXPIklobGViTC50LRkWhBLA4YlQVxYKbHVeZ5YZGVBhTVW5oxOAB7mFq713hmrOlettFsrjNTmC-rPF4JzNjjdR74y5c7Ynh2A8y2gfaFr63RTVH7HSZQkjPDA8YH7rGqz_n-zShdp6IggwkGsfG--fkXt3hUXVDC1fJgpEiP5kt0t1RX9BlBEgc0</recordid><startdate>200609</startdate><enddate>200609</enddate><creator>Enders, Jan</creator><creator>Gebauer, Corinna</creator><creator>Pulzer, Ferdinand</creator><creator>Robel-Tillig, Eva</creator><creator>Knüpfer, Matthias</creator><general>Blackwell Publishing Ltd</general><general>Blackwell</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope></search><sort><creationdate>200609</creationdate><title>Morphine-related apnoea in CPAP-treated preterm neonates</title><author>Enders, Jan ; Gebauer, Corinna ; Pulzer, Ferdinand ; Robel-Tillig, Eva ; Knüpfer, Matthias</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4147-afffd11f4c6948234f897eb7a3d5a72f3c41182067f881fabb9f0f8c37fef8b53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2006</creationdate><topic>Analgesia</topic><topic>Analgesics, Opioid - administration & dosage</topic><topic>Analgesics, Opioid - adverse effects</topic><topic>Apnea - chemically induced</topic><topic>apnoea</topic><topic>Biological and medical sciences</topic><topic>Continuous Positive Airway Pressure - adverse effects</topic><topic>General aspects</topic><topic>Humans</topic><topic>Infant, Newborn</topic><topic>Infant, Premature</topic><topic>Infant, Premature, Diseases - chemically induced</topic><topic>Medical sciences</topic><topic>morphine</topic><topic>Morphine - administration & dosage</topic><topic>Morphine - adverse effects</topic><topic>pain</topic><topic>preterm infants</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Time Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Enders, Jan</creatorcontrib><creatorcontrib>Gebauer, Corinna</creatorcontrib><creatorcontrib>Pulzer, Ferdinand</creatorcontrib><creatorcontrib>Robel-Tillig, Eva</creatorcontrib><creatorcontrib>Knüpfer, Matthias</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><jtitle>Acta Paediatrica</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Enders, Jan</au><au>Gebauer, Corinna</au><au>Pulzer, Ferdinand</au><au>Robel-Tillig, Eva</au><au>Knüpfer, Matthias</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Morphine-related apnoea in CPAP-treated preterm neonates</atitle><jtitle>Acta Paediatrica</jtitle><addtitle>Acta Paediatr</addtitle><date>2006-09</date><risdate>2006</risdate><volume>95</volume><issue>9</issue><spage>1087</spage><epage>1092</epage><pages>1087-1092</pages><issn>0803-5253</issn><eissn>1651-2227</eissn><abstract>Background: Morphine can be used to treat pain in preterm neonates with CPAP because of its analgetic potency; however, it is known to induce apnoea. Aim: To evaluate this risk of apnoea. Methods: We retrospectively analysed 91 preterm neonates with CPAP who received morphine intravenously. The incidence of apnoea 4 h before and after morphine administration was compared. The data were analysed for three dosage groups (<0.01, 0.01–0.03 and 0.03 mg/kg) and according to the incidence of apnoea before morphine application. Results: In the whole group (gestational age 29.1±2.9 wk, morphine dosage 0.017±0.01 mg/kg) we did not find differences in apnoea before and after morphine (0.9±1.8 vs 1.1±1.8 apnoea). The only significant increase in apnoea was seen in the subgroup of patients receiving > 0.03 mg/kg (0.3±0.67 vs 1.5±2.5 apnoea). Interestingly, we found a significantly delayed increase in apnoea in the fourth hour.
Conclusion: Morphine in preterm infants with CPAP is not widely accepted practice until further randomized studies evaluate efficacy and safety. Morphine in a low dosage (≤0.03 mg/kg) did not significantly increase the apnoea rate in CPAP‐treated preterm infants. For clinical work, it is very important to note that morphine‐related apnoea may appear with a delay of approximately 4 h.</abstract><cop>Oxford, UK</cop><pub>Blackwell Publishing Ltd</pub><pmid>16938755</pmid><doi>10.1080/08035250600577871</doi><tpages>6</tpages></addata></record> |
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| subjects | Analgesia Analgesics, Opioid - administration & dosage Analgesics, Opioid - adverse effects Apnea - chemically induced apnoea Biological and medical sciences Continuous Positive Airway Pressure - adverse effects General aspects Humans Infant, Newborn Infant, Premature Infant, Premature, Diseases - chemically induced Medical sciences morphine Morphine - administration & dosage Morphine - adverse effects pain preterm infants Retrospective Studies Risk Factors Time Factors |
| title | Morphine-related apnoea in CPAP-treated preterm neonates |
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