Opioid withdrawal in neonates after continuous infusions of morphine or fentanyl during extracorporeal membrane oxygenation.

BACKGROUND

Complications of opioid analgesia include tolerance and withdrawal.

OBJECTIVES

To determine the effects of morphine and fentanyl on the prevalence of withdrawal after extracorporeal membrane oxygenation.

METHODS

Two groups of neonates were compared during and after extracorporeal membrane oxygenation: a prospective group receiving a continuous infusion of morphine for analgesia and sedation and a retrospective group who had received a continuous infusion of fentanyl.

RESULTS

Neonates receiving morphine required significantly less supplemental analgesia (P < .001) than did neonates who had received fentanyl and had a significantly lower prevalence of withdrawal after the therapy (P = .01). Neonates receiving morphine were discharged from the hospital a mean of 9.6 days sooner (P = .01) than neonates who had received fentanyl.

CONCLUSIONS

Morphine may offer marked advantages over fentanyl for providing continuous analgesia and sedation in neonates.