Schuurmans Juliette, Benders Manon, Lemmers Petra, van Bel Frank
Department of Neonatology, University Medical Center , Utrecht , The Netherlands.
J Matern Fetal Neonatal Med. 2015 Jan;28(2):222-8. doi: 10.3109/14767058.2014.908178. Epub 2014 Apr 29.
Preterm infants requiring intensive care experience a large number of stressful and painful procedures. Management of stress and pain is therefore an important issue. This review provides an overview of the research on the use of morphine and its neurodevelopmental effects on this vulnerable group of neonates.
A structural literature search of both experimental and clinical data has been done using an electronic database (PubMed), but also relevant reference lists and related articles were used.
A total of 39 sources were considered relevant for this review to elucidate the effects of morphine on the developing brain. The results showed that both animal experimental and clinical data displayed conflicting results on the effects of neonatal morphine on neurodevelopmental outcome. However, in contrast to specific short-term neurological outcomes long-term neurodevelopmental outcome does not seem to be adversely affected by morphine.
After a careful review of the literature, no definite conclusions concerning the effects of neonatal morphine on the long-term neurodevelopmental outcome in extremely premature neonates can be drawn. More prospectively designed trials should be conducted using reliable and validated pain assessment scores to evaluate effects of morphine on long-term neurodevelopmental outcome to demonstrate a beneficial or adverse effect of morphine in preterm infants.
需要重症监护的早产儿要经历大量有压力和痛苦的操作。因此，压力和疼痛的管理是一个重要问题。本综述概述了关于吗啡使用及其对这一脆弱新生儿群体神经发育影响的研究。
使用电子数据库（PubMed）对实验和临床数据进行了结构化文献检索，同时也使用了相关参考文献列表和相关文章。
共有39篇文献被认为与本综述相关，以阐明吗啡对发育中大脑的影响。结果表明，动物实验和临床数据在新生儿吗啡对神经发育结局的影响方面呈现出相互矛盾的结果。然而，与特定的短期神经学结局不同，长期神经发育结局似乎并未受到吗啡的不利影响。
在对文献进行仔细审查后，无法就新生儿吗啡对极早产儿长期神经发育结局的影响得出明确结论。应进行更多前瞻性设计的试验，使用可靠且经过验证的疼痛评估评分来评估吗啡对长期神经发育结局的影响，以证明吗啡对早产儿的有益或不利影响。
