Hall Eric S, Rice Ward R, Folger Alonzo T, Wexelblatt Scott L
Perinatal Institute, Section of Neonatology, Perinatal and Pulmonary Biology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio.
Am J Perinatol. 2018 Mar;35(4):405-412. doi: 10.1055/s-0037-1608634. Epub 2017 Nov 7.
The objective of this study was to compare duration of opioid treatment and length of stay outcomes for neonatal abstinence syndrome (NAS) using sublingual buprenorphine versus traditional weaning with methadone or morphine.
This retrospective cohort analysis evaluated infants treated for NAS at a single community hospital from July 2013 through June 2017. A standardized weaning protocol was introduced in June 2015, allowing for treatment with sublingual buprenorphine regardless of type of intrauterine opioid exposure. General linear models were used to calculate adjusted mean duration of opioid treatment and length of hospitalization with 95% confidence intervals for infants treated with buprenorphine compared with traditional weaning with either methadone or morphine.
A total of 360 infants were treated with either buprenorphine ( = 174) or a traditional opioid ( = 186). Infants treated with buprenorphine experienced a 3.0-day reduction in opioid treatment duration of 7.4 (6.3-8.5) versus 10.4 (9.3-11.5) days ( < 0.001) and a 2.8-day reduction in length of stay of 12.4 (11.3-13.6) versus 15.2 (14.1-16.4) days ( < 0.001).
Our study provides an independent confirmation that among infants experiencing NAS following a wide array of intrauterine opioid exposures, buprenorphine weaning supports a shortened treatment duration compared with conventional weaning agents.
本研究的目的是比较使用舌下含服丁丙诺啡与传统的美沙酮或吗啡戒断疗法治疗新生儿戒断综合征（NAS）时的阿片类药物治疗持续时间和住院时间。
这项回顾性队列分析评估了2013年7月至2017年6月在一家社区医院接受NAS治疗的婴儿。2015年6月引入了标准化的戒断方案，允许使用舌下含服丁丙诺啡进行治疗，无论宫内阿片类药物暴露类型如何。使用一般线性模型计算接受丁丙诺啡治疗的婴儿与使用美沙酮或吗啡进行传统戒断治疗的婴儿相比，经调整的阿片类药物治疗平均持续时间和住院时间，并给出95%置信区间。
共有360名婴儿接受了丁丙诺啡治疗（n = 174）或传统阿片类药物治疗（n = 186）。接受丁丙诺啡治疗的婴儿阿片类药物治疗持续时间从10.4（9.3 - 11.5）天减少至7.4（6.3 - 8.5）天，减少了3.0天（P < 0.001）；住院时间从15.2（14.1 - 16.4）天减少至12.4（11.3 - 13.6）天，减少了2.8天（P < 0.001）。
我们的研究提供了独立的证据，表明在因多种宫内阿片类药物暴露而出现NAS的婴儿中，与传统戒断药物相比，丁丙诺啡戒断疗法可缩短治疗持续时间。
