Opiate treatment for opiate withdrawal in newborn infants
Sübutlu məlumatların xülasələri
06.06.2017 • Sonuncu dəyişiklik 06.06.2017
Editors
Opiates, as compared to supportive care only, appear to reduce the time to regain birth weight and reduce the duration of supportive care, but increase the duration of hospital stay in the treatment of neonatal abstinence syndrome due to withdrawal from opiates.
A Cochrane review included 9 studies with a total of 645 infants. The studies enrolled infants of mothers who had used opiates with or without other drugs during pregnancy.
- Opiate (morphine) vs supportive care only: One study found no significant effect on treatment failure (RR 1.29, 95% CI 0.41 to 4.07), a significant increase in hospital stay (MD 15.0 days, 95% CI 8.9 to 21.1) and significant reductions in time to regain birthweight (MD –2.8 days, 95% –5.3 to –0.3) and duration of supportive care (MD –197.2 minutes/day, 95% CI –274.2 to –120.3).
- Opiate vs phenobarbitone: Meta-analysis of four studies found no significant difference in treatment failure (RR 0.76, 95% CI 0.51 to 1.11). Single studies reported reduction in treatment failure, reduction in duration of treatment and admission to the nursery or reduction in seizures in favour of opiate treatment.
- Opiate vs diazepam: Meta-analysis of two studies found a significant reduction in treatment failure (RR 0.43, 95% CI 0.23 to 0.80) with the use of opiate.
- Different opiates (6 studies): there was insufficient data to determine safety or efficacy of any specific opiate compared to another opiate.
Reviewers' conclusions: Opiates, as compared to supportive care only, appear to reduce the time to regain birth weight and reduce the duration of supportive care, but increase the duration of hospital stay; there is no evidence of effect on treatment failure. When compared to phenobarbital, opiates may reduce the incidence of seizures but, overall, there is no evidence of effect on treatment failure. When compared to diazepam, opiates reduce the incidence of treatment failure.
Comment: The quality of evidence is downgraded by study quality (inadequate or unclear allocation concealment and lack of blinding).
Ədəbiyyat
- Osborn DA, Jeffery HE, Cole MJ. Opiate treatment for opiate withdrawal in newborn infants. Cochrane Database Syst Rev 2010;(10):CD002059. .