Severe withdrawal syndrome in three newborns subjected to continuous opioid infusion and seizure activity dependent on brain hypoxia - ischemia. A possible link

Authors: BACHIOCCO, VALERIA; LORENZINI, LAURA; BARONCINI, SIMONETTA

Source: Paediatric Anaesthesia, Volume 16, Number 10, October 2006 , pp. 1057-1062(6)

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Abstract:

Summary Background

: The aim of this investigation was to verify whether brain hypoxia represented a risk factor for the occurrence and severity of opioid abstinence syndrome. Methods

: Three newborns who manifested seizure activity as a result of hypoxia, focal brain ischemia, and hypoxia and sepsis, respectively, were compared with 17 neonates who suffered from hypoxia without developing seizure activity. Results

: The first three neonates suffered a severe withdrawal syndrome (a rating on the neonatal abstinence score >17), the others did not. Conclusions

: It is hypothesized that brain hypoxia facilitated the occurrence and severity of the withdrawal syndrome because some key neurochemical processes (such as N-methyl-d-aspartate activation, protein kinase C activation and nitric oxide production) are common to both phenomena.

Keywords: newborns; opioid; tolerance; withdrawal syndrome; brain hypoxia; sepsis

Document Type: Research article

DOI: http://dx.doi.org/10.1111/j.1460-9592.2006.01915.x

Publication date: 2006-10-01