Effect of increased opiate exposure on three years neurodevelopmental outcome in extremely preterm infants.
Early Hum Dev
; 123: 1-5, 2018 08.
Article
in En
| MEDLINE
| ID: mdl-29935388
ABSTRACT
BACKGROUND:
International guidelines recommend the use of item based scales for the assessment of pain and sedation. In our previous study, the implementation of the Neonatal Pain Agitation and Sedation Scale (N-PASS), and the associated systematic assessment and treatment of pain and sedation reduced pain and over-sedation in our intervention group, but lead to a significant increase of individual opiate exposure. This increased opiate exposure was not associated with impaired motor and mental development at one year of age. As one-year follow-up is not necessarily representative for future outcomes, we retested our sample at three years of age.METHODS:
Fifty-three patients after (intervention group) and 61 before implementation (control group) of the N-PASS and the Vienna Protocol for the Management of Neonatal Pain and Sedation (VPNPS), were compared for motor, mental and behavioural development at three-years follow-up using the Bayley Scales of Infant Development.RESULTS:
Cumulative opiate exposure was not associated with mental (pâ¯=â¯.31) and motor (pâ¯=â¯.20) problems when controlling for other important medical conditions, but was associated to lower behavioural scores (pâ¯=â¯.007). No statistically significant differences were found with regard to mental (pâ¯=â¯.65), psychomotor (pâ¯=â¯.12) and behavioural (pâ¯=â¯.61) development before and after the implementation of the N-PASS and the VPNPS.CONCLUSION:
Implementing a neonatal pain and sedation protocol increased opiate exposure without affecting neurodevelopmental outcome at three-years of age.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Child Development
/
Infant, Extremely Premature
/
Analgesics, Opioid
Type of study:
Guideline
/
Observational_studies
/
Risk_factors_studies
Limits:
Child, preschool
/
Female
/
Humans
/
Male
/
Newborn
Language:
En
Journal:
Early Hum Dev
Year:
2018
Document type:
Article