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Premedication for intubation with morphine causes prolonged depression of electrocortical background activity in preterm infants.

Norman, Elisabeth LU ; Wikström, Sverre; Rosén, Ingmar LU ; Fellman, Vineta LU and Hellström-Westas, Lena LU (2013) In Pediatric Research 73. p.87-94
Abstract
Background:Sedative and analgesic medications are used in critically ill newborns, but little is known about their effects on electrocortical activity in preterm infants. We hypothesized that morphine might induce prolonged neurodepression, independent of blood pressure, compared with rapid sequence induction/intubation (RSI).Methods:Of 34 infants enrolled into a randomized controlled trial (RCT) comparing RSI (including thiopental 2-3 mg/kg and remifentantil 1 microg/kg) with morphine (0.3 mg/kg) as premedication for intubation, 28 infants (n=14+14; median gestational age 26.1 weeks and postnatal age 138 h) had continuous two-channel amplitude-integrated electroencephalogram (aEEG/EEG) and blood pressure monitoring during 24 h after the... (More)
Background:Sedative and analgesic medications are used in critically ill newborns, but little is known about their effects on electrocortical activity in preterm infants. We hypothesized that morphine might induce prolonged neurodepression, independent of blood pressure, compared with rapid sequence induction/intubation (RSI).Methods:Of 34 infants enrolled into a randomized controlled trial (RCT) comparing RSI (including thiopental 2-3 mg/kg and remifentantil 1 microg/kg) with morphine (0.3 mg/kg) as premedication for intubation, 28 infants (n=14+14; median gestational age 26.1 weeks and postnatal age 138 h) had continuous two-channel amplitude-integrated electroencephalogram (aEEG/EEG) and blood pressure monitoring during 24 h after the intubation. Thirteen infants not receiving any additional medication constituted the primary study group. Visual and quantitative analyses of aEEG/EEG and blood pressure were performed in 3-h epochs.Results:RSI was associated with aEEG/EEG depression lasting less than 3 h. Morphine premedication resulted in aEEG/EEG depression with more discontinuous background and less developed cyclicity for 24 h, and during the first 9 h interburst intervals were significantly increased compared to RSI. The difference was not related to blood pressure.Conclusion:Premedication with morphine is associated with prolonged aEEG/EEG depression independent of blood pressure changes, and may not be optimal for short procedures.Pediatric Research (2012); doi:10.1038/pr.2012.153. (Less)
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author
organization
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type
Contribution to journal
publication status
published
subject
in
Pediatric Research
volume
73
pages
87 - 94
publisher
International Pediatric Foundation Inc.
external identifiers
  • wos:000313307900014
  • pmid:23128421
  • scopus:84872059584
ISSN
1530-0447
DOI
10.1038/pr.2012.153
language
English
LU publication?
yes
id
8a010d47-6cab-40d6-af79-5fba67cdbab6 (old id 3219219)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/23128421?dopt=Abstract
date added to LUP
2012-12-03 13:17:54
date last changed
2019-07-30 01:23:21
@article{8a010d47-6cab-40d6-af79-5fba67cdbab6,
  abstract     = {Background:Sedative and analgesic medications are used in critically ill newborns, but little is known about their effects on electrocortical activity in preterm infants. We hypothesized that morphine might induce prolonged neurodepression, independent of blood pressure, compared with rapid sequence induction/intubation (RSI).Methods:Of 34 infants enrolled into a randomized controlled trial (RCT) comparing RSI (including thiopental 2-3 mg/kg and remifentantil 1 microg/kg) with morphine (0.3 mg/kg) as premedication for intubation, 28 infants (n=14+14; median gestational age 26.1 weeks and postnatal age 138 h) had continuous two-channel amplitude-integrated electroencephalogram (aEEG/EEG) and blood pressure monitoring during 24 h after the intubation. Thirteen infants not receiving any additional medication constituted the primary study group. Visual and quantitative analyses of aEEG/EEG and blood pressure were performed in 3-h epochs.Results:RSI was associated with aEEG/EEG depression lasting less than 3 h. Morphine premedication resulted in aEEG/EEG depression with more discontinuous background and less developed cyclicity for 24 h, and during the first 9 h interburst intervals were significantly increased compared to RSI. The difference was not related to blood pressure.Conclusion:Premedication with morphine is associated with prolonged aEEG/EEG depression independent of blood pressure changes, and may not be optimal for short procedures.Pediatric Research (2012); doi:10.1038/pr.2012.153.},
  author       = {Norman, Elisabeth and Wikström, Sverre and Rosén, Ingmar and Fellman, Vineta and Hellström-Westas, Lena},
  issn         = {1530-0447},
  language     = {eng},
  pages        = {87--94},
  publisher    = {International Pediatric Foundation Inc.},
  series       = {Pediatric Research},
  title        = {Premedication for intubation with morphine causes prolonged depression of electrocortical background activity in preterm infants.},
  url          = {http://dx.doi.org/10.1038/pr.2012.153},
  volume       = {73},
  year         = {2013},
}