Enteral Docosahexaenoic Acid Reduces Analgesic Administration in Neonates Undergoing Cardiovascular Surgery.
Neonates undergoing surgery require analgesic medication to ameliorate acute pain. These medications produce negative side effects. Docosahexaenoic acid (DHA) has an antinociceptive effect in animals, but this has not been evaluated in human neonates. We evaluated the DHA effect on cumulative dose and duration of analgesics administered to neonates undergoing cardiovascular surgery.



A secondary analysis was performed with data from a clinical trial, in which enteral DHA was administered perioperatively compared with sunflower oil (SO). Present study assessed the antinociceptive effect of DHA by measuring the cumulative dose and duration of analgesics administered during postoperative stay in a neonatal intensive care unit. Multivariate linear regression models were performed.



Seventeen neonates received DHA and 18 received SO in the control group. Compared with the control group, the DHA group received lower cumulative dose (14.6 ± 2.2 vs. 25.2 ± 4.8 μg/kg, p = 0.029) and shorter duration of buprenorphine (2 days (1-8) vs. 4.5 days (1-12); p = 0.053). After adjusting for confounders, the DHA group received significantly lesser buprenorphine (β = -27 μg/kg, p = 0.028; R2 model = 0.90) for shorter duration (β = -9 days, p = 0.003; R2 model = 0.94). No differences in fentanyl or ketorolac were detected.



Buprenorphine administration was reduced in neonates who received DHA, suggesting that DHA likely has analgesic effects.
Unit of Medical Research in Nutrition, Hospital de Pediatria, Mexico City, Mexico.
Mariela
M
Bernabe-Garcia
Mardia
M
López-Alarcon
Alfredo
A
Salgado-Sosa
Raul
R
Villegas-Silva
Jorge
J
Maldonado-Hernandez
Maricela
M
Rodríguez-Cruz
Rodolfo
R
Rivas-Ruiz
Luis
L
Chavez-Sanchez
Francisco A
FA
Blanco-Favela
Javier
J
Mancilla-Ramirez
Virginia
V
Gordillo-Alvarez
Olivia
O
Madrigal-Muñiz
D059787:Acute Pain / Q000188:drug therapy / Q000517:prevention & control; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects / Q000627:therapeutic use; D001011:Aorta / Q000002:abnormalities / Q000601:surgery*; D058366:Blalock-Taussig Procedure / Q000009:adverse effects*; D002047:Buprenorphine / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D018376:Cardiovascular Abnormalities / Q000601:surgery*; D019587:Dietary Supplements / Q000009:adverse effects; D004281:Docosahexaenoic Acids / Q000009:adverse effects / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006776:Hospitals, Pediatric; D006801:Humans; D007227:Infant Nutritional Physiological Phenomena; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D008297:Male; D008800:Mexico; D010149:Postoperative Pain / Q000188:drug therapy / Q000517:prevention & control*; D019990:Perioperative Care / Q000009:adverse effects; D013997:Time Factors
D000701:Analgesics, Opioid; D000894:Anti-Inflammatory Agents, Non-Steroidal; D004281:Docosahexaenoic Acids; D002047:Buprenorphine