Severe withdrawal syndrome in three newborns subjected to continuous opioid infusion and seizure activity dependent on brain hypoxia--ischemia. A possible link.
BACKGROUND
The aim of this investigation was to verify whether brain hypoxia represented a risk factor for the occurrence and severity of opioid abstinence syndrome.


METHODS
Three newborns who manifested seizure activity as a result of hypoxia, focal brain ischemia, and hypoxia and sepsis, respectively, were compared with 17 neonates who suffered from hypoxia without developing seizure activity.


RESULTS
The first three neonates suffered a severe withdrawal syndrome (a rating on the neonatal abstinence score>17), the others did not.


CONCLUSIONS
It is hypothesized that brain hypoxia facilitated the occurrence and severity of the withdrawal syndrome because some key neurochemical processes (such as N-methyl-D-aspartate activation, protein kinase C activation and nitric oxide production) are common to both phenomena.
Bachiocco
Valeria
V
Department of Anesthesia-Analgesia and Intensive Care Unit, S. Orsola Hospital, Bologna, Italy. valebachiocco@libero.it
Lorenzini
Laura
L
Baroncini
Simonetta
S
D000465:Algorithms; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use*; D004569:Electroencephalography; D004933:Esophageal Atresia / Q000601:surgery; D005260:Female; D006548:Hernia, Diaphragmatic / Q000601:surgery; D065630:Hernias, Diaphragmatic, Congenital; D006801:Humans; D020925:Hypoxia-Ischemia, Brain / Q000150:complications*; D007231:Infant, Newborn; D007262:Infusions, Intravenous; D008297:Male; D009357:Neonatal Abstinence Syndrome / Q000150:complications*; D012189:Retrospective Studies; D012640:Seizures / Q000209:etiology*
D000701:Analgesics, Opioid