Akkawi Ranaa, Eksborg Staffan, Andersson Asa, Lundeberg Stefan, Bartocci Marco
Karolinska Pharmacy, Karolinska University Hospital, Stockholm, Sweden.
Acta Paediatr. 2009 Mar;98(3):442-7. doi: 10.1111/j.1651-2227.2008.01128.x. Epub 2008 Nov 28.
Opioids are common drugs for pain treatment in preterm newborn infants, in spite of several adverse effects. Constipation is a frequent problem when opioids are used in both adults and neonates. Although several studies indicate that the oral administration of naloxone hydrochloride (NH) improves intestinal motility during opioid therapy, there is still a lack of evidence in newborns.
The aim of this study was to assess the efficacy of NH against reduced intestinal motility during opioid treatment.
A retrospective cohort study was performed. We analysed the medical records of fifteen infants (Group 1) treated with continuous morphine (MO) infusion and fourteen infants (Group 2) treated with both oral NH (3 microg/kg 4 times daily) and MO.
There was no statistically significant difference in the total MO dose. Infants treated both with NH and MO had a tendency to improve their mean stool frequency/day. A statistically significant improvement was observed in the mean total food intake (mL/kg/day) of the infants treated with NH (p = 0.014). No difference in the mean food retention between the two groups was observed.
Orally administrated NH seems to improve intestinal motility resulting in increased food intake/day and improved stool frequency/day in premature newborn infants treated with MO. Further studies are needed to corroborate these findings.
尽管存在多种不良反应，但阿片类药物仍是早产新生儿疼痛治疗的常用药物。便秘是成人和新生儿使用阿片类药物时常见的问题。虽然多项研究表明口服盐酸纳洛酮（NH）可改善阿片类药物治疗期间的肠道蠕动，但新生儿方面仍缺乏证据。
本研究旨在评估NH对阿片类药物治疗期间肠道蠕动减弱的疗效。
进行了一项回顾性队列研究。我们分析了15例接受持续吗啡（MO）输注治疗的婴儿（第1组）和14例同时接受口服NH（3微克/千克，每日4次）和MO治疗的婴儿（第2组）的病历。
总MO剂量无统计学显著差异。同时接受NH和MO治疗的婴儿平均每日排便次数有增加趋势。接受NH治疗的婴儿平均每日总食物摄入量（毫升/千克/天）有统计学显著改善（p = 0.014）。两组之间的平均食物潴留无差异。
口服NH似乎可改善肠道蠕动，使接受MO治疗的早产新生儿每日食物摄入量增加，每日排便次数增多。需要进一步研究来证实这些发现。
