Randomised controlled trial of low dose fentanyl infusion in preterm infants with hyaline membrane disease

摘要

Aim—To evaluate the effects of low dosefentanyl infusion analgesia on behavioural and neuroendocrine stressresponse and short term outcome in premature infants ventilated forhyaline membrane disease.
METHODS—Twenty seven ventilated preterm infantswere randomly assigned to receive a mean fentanyl infusion of 1.1 (0.08 SE) µg/kg/h for 75 (5) hours, and 28 untreated infants wereconsidered a control group. A behavioural sedation score was used toassess the infants' behaviour. Urinary metanephrine and thenormetanephrine:creatinine molar ratio were determined at 0, 24, 48 and72 hours. Outcome data and ventilatory indexes were recorded for each infant.
RESULTS—The fentanyl group showed significantlylower behavioural stress scores and O2 desaturations thancontrols and lower urinary concentrations of metanephrine andnormetanephrine at 24, 48,72 hours. The two groups showed nosignificant difference in ventilatory variables or short term outcome.
CONCLUSIONS—A short course of low dose fentanylinfusion reduces behavioural sedation scores, O2desaturations and neuroendocrine stress response in preterm ventilated infants.