Authors: Akkawi, Ranaa; Eksborg, Staffan; Andersson, Åsa¹; Lundeberg, Stefan²; Bartocci, Marco³

Source: Acta Pædiatrica, Volume 98, Number 3, March 2009 , pp. 442-447(6)

Publisher: Wiley-Blackwell

Abstract:

Background: Opioids are common drugs for pain treatment in preterm newborn infants, in spite of several adverse effects. Constipation is a frequent problem when opioids are used in both adults and neonates. Although several studies indicate that the oral administration of naloxone hydrochloride (NH) improves intestinal motility during opioid therapy, there is still a lack of evidence in newborns.

Aim: The aim of this study was to assess the efficacy of NH against reduced intestinal motility during opioid treatment.

Methods: A retrospective cohort study was performed. We analysed the medical records of fifteen infants (Group 1) treated with continuous morphine (MO) infusion and fourteen infants (Group 2) treated with both oral NH (3 μg/kg 4 times daily) and MO.

Results: There was no statistically significant difference in the total MO dose. Infants treated both with NH and MO had a tendency to improve their mean stool frequency/day. A statistically significant improvement was observed in the mean total food intake (mL/kg/day) of the infants treated with NH (p = 0.014). No difference in the mean food retention between the two groups was observed.

Conclusion: Orally administrated NH seems to improve intestinal motility resulting in increased food intake/day and improved stool frequency/day in premature newborn infants treated with MO. Further studies are needed to corroborate these findings.

Keywords: Constipation; Enteral nutrition; Gastrointestinal motility; Morphine; Naloxone; Newborn premature infant; Pain

Document Type: Research article

DOI: http://dx.doi.org/10.1111/j.1651-2227.2008.01128.x

Affiliations: 1: Karolinska Pharmacy, Karolinska University Hospital, Stockholm, Sweden 2: Department of anaesthesiology, Unit for Paediatric Pain Treatment, Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden 3: Department of Women and Child Health, Neonatal Intensive Care and Research Units, Astrid Lindgren Children's Hospital, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden

Publication date: 2009-03-01

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