84069
document
Pain relief can reduce hypoxemia in distressed neonates during routine treatment procedures . OBJECTIVE To determine whether the use of opioids could reduce the hypoxemia and hemodynamic instability associated with routine intensive care procedures in neonates with respiratory distress . DESIGN Randomized and placebo-controlled study . METHODS Physiological , plasma beta-endorphin , cortisol , and glucose responses to routine treatment procedures were studied in 84 mechanically ventilated distressed neonates randomized into groups receiving 1 mg/kg meperidine or 0.9 % saline 15 minutes before tracheal suction or routine nursing care . RESULTS The duration of hypoxemia ( transcutaneous partial pressure of O2 < 6.6 kPa ( < 50 mm Hg ) and/or arterial blood oxygen saturation < 80 % ) during treatment procedures was significantly longer in the saline group ( mean 82 vs 36 seconds , P = .001 ) and distress quantified by a novel behavioral scoring method was much higher . Changes in arterial blood pressure , heart rate , or plasma beta-endorphin , cortisol , and glucose concentration did not show any statistically significant differences between the groups . CONCLUSION Newborns with respiratory difficulties often suffer from hypoxemia during essential treatment procedures . The use of opioid analgesia may reduce the duration of hypoxemia and the associated distress and , therefore , may improve the long-term results of neonatal intensive care .
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Intervention_Pharmacological
opioids
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Intervention_Control
placebo-controlled
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Intervention_Pharmacological
1 mg/kg meperidine
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Intervention_Control
0.9 % saline
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Intervention_Physical
tracheal suction
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Intervention_Physical
routine nursing care
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Intervention_Pharmacological
opioid analgesia
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Outcome_Physical
hypoxemia
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Outcome_Physical
hypoxemia and hemodynamic instability
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Outcome_Physical
duration of hypoxemia ( transcutaneous partial pressure of O2
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Outcome_Physical
arterial blood oxygen saturation
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Outcome_Physical
arterial blood pressure , heart rate , or plasma beta-endorphin , cortisol , and glucose concentration
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Outcome_Physical
duration of hypoxemia
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Outcome_Physical
distress
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Participant_Condition
distressed
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Participant_Age
neonates
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Participant_Age
neonates
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Participant_Condition
respiratory distress .
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Participant_Sample-size
84
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Participant_Condition
mechanically ventilated distressed
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Participant_Age
Newborns
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Participant_Condition
respiratory difficulties