Treatment of opioid withdrawal in neonates with morphine, phenobarbital, or chlorpromazine: a randomized double-blind trial.
Three suitable compounds (morphine, chlorpromazine, and phenobarbital) to treat neonatal abstinence syndrome were compared in a prospective multicenter, double-blind trial. Neonates exposed to opioids in utero were randomly allocated to one of three treatment groups. When a predefined threshold of a...
| Publicado en: | European Journal of Pediatrics Vol. 179; no. 1; pp. 141 - 150 |
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| Autores principales: | , , , , |
| Formato: | research randomized controlled trial Journal Article |
| Publicado: |
Springer Nature
Jan2020
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=141049151&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 141049151 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 03406199 CR1 jtl: European Journal of Pediatrics issn: 03406199 maglogo: N pubinfo: dt: Jan2020 vid: 179 iid: 1 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 141049151 141049151 NLM31691849 141049151 10.1007/s00431-019-03486-6 NLM31691849 141049151 ppf: 141 ppct: 9 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Treatment of opioid withdrawal in neonates with morphine, phenobarbital, or chlorpromazine: a randomized double-blind trial. aug: au: Zimmermann, Urs Rudin, Christoph Duò, Angelo Held, Leonhard Bucher, Hans Ulrich affil: Department of Neonatology, Spital Bülach, CH–8180, Bülach, Switzerland sug: subj: Morphine Therapeutic Use Phenobarbital Therapeutic Use Hypnotics and Sedatives Therapeutic Use Neonatal Abstinence Syndrome Drug Therapy Chlorpromazine Therapeutic Use Dopamine Antagonists Therapeutic Use Analgesics, Opioid Adverse Effects Dose-Response Relationship, Drug Human Prospective Studies Analgesics, Opioid Therapeutic Use Infant, Newborn Drug Therapy, Combination Double-Blind Studies Treatment Outcomes Female Male Drug Administration Schedule Validation Studies Comparative Studies Evaluation Research Multicenter Studies Randomized Controlled Trials Infant, Newborn: birth-1 month Female Male ab: Three suitable compounds (morphine, chlorpromazine, and phenobarbital) to treat neonatal abstinence syndrome were compared in a prospective multicenter, double-blind trial. Neonates exposed to opioids in utero were randomly allocated to one of three treatment groups. When a predefined threshold of a modified Finnegan score was reached, treatment started and increased stepwise until symptoms were controlled. If symptoms could not be controlled with the predefined maximal dose of a single drug, a second drug was added. Among 143 infants recruited, 120 needed pharmacological treatment. Median length of treatment for morphine was 22 days (95% CI 18 to 33), for chlorpromazine 25 days (95% CI 21 to 34), and for phenobarbital 32 days (95% CI 27 to 38) (p = ns). In the morphine group, only 3% of infants (1/33) needed a second drug; in the chlorpromazine group, this proportion was 56% (24/43), and in the phenobarbital group 30% (13/44).Conclusion: None of the drugs tested for treating neonatal abstinence syndrome resulted in a significantly shorter treatment length than the others. As morphine alone was able to control symptoms in almost all infants, it may be preferred to the two other drugs but should still be tested against more potent opioids such as buprenorphine.Trial registration: At ClinicalTrials.gov NCT02810782 (registered retrospectively).What is Known:• Neonates exposed to opiates in utero and presenting with withdrawal symptoms should first be treated by non-pharmacological supportive measures.• In those who fail, drugs have to be given, but there is controversy which drug is best.What is New:• Among three candidates, morphine, chlorpromazine and phenobarbital, none resulted in significantly shorter treatment time.• As morphine alone was able to control symptoms in almost all infants, it may be preferred to the two other drugs. pubtype: Academic Journal doctype: research randomized controlled trial Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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