Department of Pediatric Cardiology, Goethe University Hospital Frankfurt, Frankfurt am Main, Germany.
Acta Paediatr. 2010 Feb;99(2):209-14. doi: 10.1111/j.1651-2227.2009.01547.x. Epub 2009 Oct 19.
The objective of this retrospective study is to compare the medical treatment of neonatal narcotic abstinence syndrome with clonidine and chloral hydrate with the commonly used combination therapy of morphine and phenobarbital.
From 1998 to 2008, a total of 133 newborns suffering from neonatal narcotic abstinence syndrome were treated at our clinic. All of these patients were born to mothers who had received methadone substitution for drug addiction during the course of pregnancy.
Twenty-nine patients received clonidine and chloral hydrate, and 64 patients were treated with morphine and phenobarbital for abstinence syndrome. The duration of treatment was significantly shorter in the clonidine/chloral hydrate group (median: 14 days vs. 35 days). Correspondingly, the period of hospitalization was also considerably shorter in the clonidine/chloral hydrate group (median: 32 days vs. 44 days). In addition, patients in the clonidine/chloral hydrate group exhibited markedly reduced withdrawal symptoms.
This study suggests that a treatment of neonatal abstinence syndrome with clonidine in omission of opiates is possible without causing short-term adverse cardiovascular effects. Considering the retrospective design of the study, controlled and prospective trials are needed.
本回顾性研究旨在比较可乐定和水合氯醛与常用的吗啡和苯巴比妥联合疗法治疗新生儿戒断综合征的医学治疗方法。
1998 年至 2008 年,我们诊所共治疗了 133 例新生儿戒断综合征患者。所有这些患者均来自在妊娠期间接受美沙酮替代毒品成瘾治疗的母亲。
29 例患者接受可乐定和水合氯醛治疗,64 例患者接受吗啡和苯巴比妥治疗戒断综合征。可乐定/水合氯醛组的治疗持续时间明显更短(中位数:14 天 vs. 35 天)。相应地,可乐定/水合氯醛组的住院时间也明显缩短(中位数:32 天 vs. 44 天)。此外,可乐定/水合氯醛组的患者戒断症状明显减轻。
本研究表明,在不引起短期不良心血管作用的情况下,使用可乐定治疗新生儿戒断综合征而不使用阿片类药物是可能的。鉴于该研究的回顾性设计,需要进行对照和前瞻性试验。