Effect of oral naloxone hydrochloride on gastrointestinal transit in premature infants treated with morphine.
BACKGROUND
Opioids are common drugs for pain treatment in preterm newborn infants, in spite of several adverse effects. Constipation is a frequent problem when opioids are used in both adults and neonates. Although several studies indicate that the oral administration of naloxone hydrochloride (NH) improves intestinal motility during opioid therapy, there is still a lack of evidence in newborns.


OBJECTIVE
The aim of this study was to assess the efficacy of NH against reduced intestinal motility during opioid treatment.


METHODS
A retrospective cohort study was performed. We analysed the medical records of fifteen infants (Group 1) treated with continuous morphine (MO) infusion and fourteen infants (Group 2) treated with both oral NH (3 microg/kg 4 times daily) and MO.


RESULTS
There was no statistically significant difference in the total MO dose. Infants treated both with NH and MO had a tendency to improve their mean stool frequency/day. A statistically significant improvement was observed in the mean total food intake (mL/kg/day) of the infants treated with NH (p = 0.014). No difference in the mean food retention between the two groups was observed.


CONCLUSIONS
Orally administrated NH seems to improve intestinal motility resulting in increased food intake/day and improved stool frequency/day in premature newborn infants treated with MO. Further studies are needed to corroborate these findings.
Akkawi
Ranaa
R
Karolinska Pharmacy, Karolinska University Hospital, Stockholm, Sweden.
Eksborg
Staffan
S
Andersson
Asa
A
Lundeberg
Stefan
S
Bartocci
Marco
M
D005260:Female; D005772:Gastrointestinal Transit / Q000187:drug effects*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D009020:Morphine / Q000037:antagonists & inhibitors / Q000627:therapeutic use*; D009270:Naloxone / Q000494:pharmacology / Q000627:therapeutic use*; D009292:Narcotic Antagonists / Q000494:pharmacology / Q000627:therapeutic use*; D010149:Postoperative Pain / Q000188:drug therapy*; D012189:Retrospective Studies
D009292:Narcotic Antagonists; D009270:Naloxone; D009020:Morphine