Dexmedetomidine versus intermittent morphine for sedation of neonates with encephalopathy undergoing therapeutic hypothermia

• Published in: Journal of perinatology 2021-09, Vol.41 (9), p.2284-2291
• Main Authors: Cosnahan, Anna S., Angert, Robert M., Jano, Eni, Wachtel, Elena V.
• Format: Article
• Language: English
• Subjects: 692/699/375/1345; 692/700/1720; Adverse events; Analgesia; Anesthesia; Brain Diseases; Care and treatment; Cohort Studies; Comparative analysis; Complications and side effects; Demography; Design parameters; Dexmedetomidine; Diseases; Dosage and administration; Encephalopathy; Enteral nutrition; Health care facilities; Hemodynamics; Humans; Hypothermia; Hypothermia, Induced; Infant, Newborn; Infants (Newborn); Medicine; Medicine & Public Health; Morphine; Neonates; Newborn babies; Opioids; Pain; Pain in children; Pain perception; Patients; Pediatric research; Pediatric Surgery; Pediatrics; Prevention; Risk factors; Safety engineering
• ISSN: 0743-8346; 1476-5543
• DOI: 10.1038/s41372-021-00998-8

Objective In March 2019, the sedative in the therapeutic hypothermia protocol at Bellevue Hospital Center and NYU Langone Health changed from morphine to dexmedetomidine. This study evaluated the impact of this change on efficacy and safety parameters. Study design This was a retrospective, observational cohort study including neonates with HIE undergoing therapeutic hypothermia ( N  = 70) at two regional perinatal medical centers. Results Baseline demographics, pain scores, hemodynamics, and time to enteral feeds were similar between dexmedetomidine ( N  = 34) and morphine ( N  = 36) patients. Dexmedetomidine patients received more breakthrough morphine (0.13 ± 0.13 vs 0.04 ± 0.09 mg/kg, p  = 0.001), but less cumulative morphine (0.13 ± 0.13 vs 1.79 ± 0.23 mg/kg, p