da Silva O, Alexandrou D, Knoppert D, Young G B
Department of Pediatrics, University of Western Ontario, Lawson Research Institute, London, Canada.
J Perinatol. 1999 Mar;19(2):120-3. doi: 10.1038/sj.jp.7200145.
To describe the association between opioid administration in the newborn period and neurologic abnormalities.
Case reports of two infants who presented with seizure activity and abnormal electroencephalograms associated with opiate administration, and reversed by naloxone.
The first was a preterm infant who developed a burst-suppression pattern on the electroencephalogram while receiving a continuous infusion of morphine and muscle paralysis. Naloxone injection during the electroencephalogram recording reversed the burst-suppression pattern. The second was a term infant receiving fentanyl infusion for pain control following surgery, who presented with motor seizure that was only partially controlled with barbiturates. An abnormal electroencephalogram recording during the opiate infusion improved with naloxone administration.
Our observations indicate a potential for neurologic abnormalities, including induction of seizure activity and electroencephalogram abnormalities, suggesting caution when opiates are used for sedation and/or pain control in the newborn period.
描述新生儿期使用阿片类药物与神经功能异常之间的关联。
两例婴儿的病例报告，这两名婴儿出现癫痫活动以及与使用阿片类药物相关的异常脑电图，且纳洛酮可逆转这些异常。
第一例是一名早产儿，在接受吗啡持续输注和肌肉麻痹治疗时脑电图出现爆发抑制模式。在脑电图记录期间注射纳洛酮逆转了爆发抑制模式。第二例是一名足月儿，术后接受芬太尼输注以控制疼痛，出现运动性癫痫，仅用巴比妥类药物部分控制。在阿片类药物输注期间的异常脑电图记录在给予纳洛酮后有所改善。
我们的观察结果表明存在神经功能异常的可能性，包括诱发癫痫活动和脑电图异常，这提示在新生儿期使用阿片类药物进行镇静和/或控制疼痛时应谨慎。
