title: Physiological, hormonal, and behavioral responses to a single fentanyl dose in intubated and ventilated preterm neonates.
abstract: OBJECTIVE
  To study the responses of ventilated preterm neonates to a single dose of opioid.
  
  
  METHODS
  In a randomized, double-blind, controlled trial, 22 mechanically ventilated preterm infants (< or = 32 weeks) were observed before medication and at 30 and 60 minutes after administration of fentanyl (3 micrograms/kg) or placebo. Heart rate, blood pressure, arterial blood gases, ventilator settings, and behavioral measures (Neonatal Facial Coding System and Modified Postoperative Comfort Score) were recorded during each period. Blood cortisol, growth hormone, glucose, and lactate were measured before and at 60 minutes after analgesia. Behavioral measures were assessed at the bedside and from video films recorded during each observation period.
  
  
  RESULTS
  Patients presented high basal levels of cortisol, growth hormone, and lactate. Behavioral scales indicated the presence of pain before any medication. In the fentanyl group, the maximum and minimum heart rate decreased and growth hormone level increased after analgesia. At the video analysis of behavioral measures, postoperative comfort score increased and neonatal facial coding system score decreased in the fentanyl group.
  
  
  CONCLUSIONS
  Single doses of fentanyl analgesia can reduce the physiologic/behavioral measures of pain and stress associated with mechanical ventilation in preterm infants.
authors.affiliation: Department of Pediatrics, Federal University of São Paulo/Escola Paulista de Medicina, Brazil.
authors.forename: R
authors.initials: R
authors.lastname: Guinsburg
authors.forename: B I
authors.initials: BI
authors.lastname: Kopelman
authors.forename: K J
authors.initials: KJ
authors.lastname: Anand
authors.forename: M F
authors.initials: MF
authors.lastname: de Almeida
authors.forename: C de A
authors.initials: Cde A
authors.lastname: Peres
authors.forename: M H
authors.initials: MH
authors.lastname: Miyoshi
mesh_terms: D000698:Analgesia; D000701:Analgesics, Opioid; D001786:Blood Glucose / Q000032:analysis; D002405:Catheterization, Central Venous; D004311:Double-Blind Method; D005260:Female; D005283:Fentanyl; D006439:Hemodynamics; D019382:Human Growth Hormone / Q000097:blood; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D007231:Infant, Newborn; D007234:Infant, Premature / Q000502:physiology*; D007442:Intubation, Intratracheal; D019344:Lactic Acid / Q000097:blood; D008297:Male; D010146:Pain / Q000503:physiopathology* / Q000517:prevention & control; D010147:Pain Measurement; D012121:Respiration, Artificial; D013997:Time Factors
chemical_list: D000701:Analgesics, Opioid; D001786:Blood Glucose; D019382:Human Growth Hormone; D019344:Lactic Acid; D005283:Fentanyl; D006854:Hydrocortisone