Ben Gurion University of the Negev, Faculty of Health Sciences, Israel; Soroka Medical Center, Neonatal Department, Israel.
Ben Gurion University of the Negev, Faculty of Health Sciences, Israel; Soroka Medical Center, Clinical Research Institute, Israel.
Early Hum Dev. 2020 Dec;151:105241. doi: 10.1016/j.earlhumdev.2020.105241. Epub 2020 Oct 23.
Morphine is widely used for sedation in premature infants and may have long-term effects on neurodevelopmental outcome.
To assess its effect on cerebral activity of extremely preterm infants.
Retrospective study in infants less than 28 weeks of gestational age (GA), treated with morphine and monitored with amplitude integrated EEG (aEEG), that were assessed at baseline and 6 consecutive 2 h periods. At each period, the background activity score and presence of cycling were determined.
A total of 140 infants were included. Background aEEG activity score worsened in 40% of the infants by 6 h after morphine initiation and cycling, initially present in 70% of the infants, could be detected in only 10% after 10 h. On multivariable analysis, adjusted for baseline aEEG score and GA, the background activity decreased by 0.85 (95% confidence interval (CI): 0.74-0.97) immediately after morphine initiation, 0.72 (CI: 0.63-0.83) at 2 h later and on average by 0.64 (CI: 0.57-0.71) at each subsequent 2 h periods. The relative risk of cycling loss at 2 h and 4 h after morphine administration was 1.58 (CI: 1.15-2.16) and 3.37 (CI: 2.23-5.08), respectively.
Continuous infusion of morphine in extremely preterm infants significantly depresses their cerebral activity soon after its commencement.
吗啡被广泛用于早产儿镇静，可能对神经发育结果有长期影响。
评估其对极早产儿脑活动的影响。
对胎龄小于 28 周、接受吗啡治疗并接受振幅整合脑电图（aEEG）监测的婴儿进行回顾性研究，在基线和连续 6 个 2 小时期间进行评估。在每个时间段，确定背景活动评分和周期性出现的情况。
共纳入 140 例婴儿。40%的婴儿在吗啡起始后 6 小时背景 aEEG 活动评分恶化，70%的婴儿最初存在周期性，10 小时后仅能检测到 10%。多变量分析显示，调整基线 aEEG 评分和胎龄后，背景活动在吗啡起始后立即下降 0.85（95%置信区间（CI）：0.74-0.97），2 小时后下降 0.72（CI：0.63-0.83），此后每个 2 小时期间平均下降 0.64（CI：0.57-0.71）。吗啡给药后 2 小时和 4 小时周期性丧失的相对风险分别为 1.58（CI：1.15-2.16）和 3.37（CI：2.23-5.08）。
极早产儿持续输注吗啡会在开始后立即显著抑制其大脑活动。
