Intranasal Fentanyl for Procedural Analgesia in Preterm Infants

Frontiers in Pain Research

Pain Research

Carol Cheng¹  Vibhuti Shah²  Charles Cheng²  Najla Tabbara³ 

[1] Department of Nursing, Mount Sinai Hospital, Toronto, ON, Canada;Department of Pediatrics, Mount Sinai Hospital, Toronto, ON, Canada;Department of Pharmacy, Mount Sinai Hospital, Toronto, ON, Canada;

关键词: fentanyl;    administration;    intranasal;    pain;    procedural;    preterm infants;   

DOI  :  10.3389/fpain.2021.815014

 received in 2021-11-14, accepted in 2021-12-27,  发布年份 2022

来源: Frontiers

【 摘 要 】

BackgroundDespite the availability of evidence-based analgesic strategies, neonatal pain management continues to be suboptimal. Intranasal (IN) fentanyl is an alternative pharmacotherapy for procedural pain in neonatal units. The objective was to evaluate the effectiveness and safety of IN fentanyl for procedural pain in preterm infants.MethodsA retrospective cohort study was conducted in infants who received IN fentanyl between May 2019 and December 2020 at an academic neonatal intensive care unit. Main outcome measures were pain responses, physiological parameters before and up to 60 min after IN fentanyl administration, and adverse events. Paired t-test and analysis of variance were used to compare pain scores and physiological parameters, respectively.ResultsThirteen infants received IN fentanyl on 22 occasions. Median (interquartile range [IQR]) gestational age and birthweight were 27 (25, 27.6) weeks and 850 (530, 1,030) grams, while median (IQR) post-menstrual age and weight were 30.9 (28.9, 32.9) weeks and 1,280 (945, 1,623) grams at the time of IN fentanyl administration. IN fentanyl was most used for lumbar puncture (55%) followed by insertion of epicutaneo-caval catheters (27%). There was a difference between the mean pre- and post-procedure Premature Infant Pain Profile scores of 1.3 (95% CI = 0.07, 2.5; p = 0.04). Physiological parameters did not differ before and up to 60 min post IN fentanyl administration (p > 0.05). Two adverse events (one apnea and one desaturation) were noted.ConclusionIn our limited experience, IN fentanyl appears to be an alternative pharmacotherapy for procedural pain management in the absence of intravenous access in preterm infants.

【 授权许可】

Unknown   
Copyright © 2022 Cheng, Tabbara, Cheng and Shah.