Use of opioids in asphyxiated term neonates: Effects on neuroimaging and clinical outcome

Danilyn M. Angeles, Nathaniel Wycliffe, David Michelson, Barbara A. Holshouser, Douglas D. Deming, William J. Pearce, Lawrence Sowers, Stephen Ashwal

Research output: Contribution to journalArticle

32 Citations (Scopus)

Abstract

Perinatal asphyxia is a common cause of neurologic morbidity in neonates who are born at term. Asphyxiated neonates are frequently treated with analgesic medications, including opioids, for pain and discomfort associated with their care. On the basis of previous laboratory studies suggesting that opioids may have neuroprotective effects, we conducted a retrospective review of medical records of 52 neonates who were admitted to our neonatal intensive care unit between 1995 and 2002 and had undergone magnetic resonance imaging (MRI) of the brain. Our review revealed that 33% of neonates received morphine or fentanyl. The neonates who received opioids also had experienced hypoxic/ischemic insults of greater magnitude as suggested by higher plasma lactate levels and lower 5-min Apgar scores. It is interesting that the MRI studies of neonates who were treated with opioids during the first week of life demonstrated significantly less brain injury in all regions studied. More important, follow-up studies of a subgroup of opioid-treated neonates whose MRI scans were obtained in the second postnatal week had better long-term neurologic outcomes. Our results suggest that the use of opioids in the first week of life after perinatal asphyxia have no significant long-term detrimental effects and may increase the brain's resistance to hypoxic-ischemic insults.

Original languageEnglish (US)
Pages (from-to)873-878
Number of pages6
JournalPediatric Research
Volume57
Issue number6
DOIs
StatePublished - Jun 2005
Externally publishedYes

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Neuroimaging
Opioid Analgesics
Asphyxia
Magnetic Resonance Imaging
Nervous System
Apgar Score
Neonatal Intensive Care Units
Brain
Fentanyl
Neuroprotective Agents
Brain Injuries
Morphine
Medical Records
Analgesics
Lactic Acid
Morbidity
Pain

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Angeles, D. M., Wycliffe, N., Michelson, D., Holshouser, B. A., Deming, D. D., Pearce, W. J., ... Ashwal, S. (2005). Use of opioids in asphyxiated term neonates: Effects on neuroimaging and clinical outcome. Pediatric Research, 57(6), 873-878. https://doi.org/10.1203/01.PDR.0000157676.45088.8C

Use of opioids in asphyxiated term neonates : Effects on neuroimaging and clinical outcome. / Angeles, Danilyn M.; Wycliffe, Nathaniel; Michelson, David; Holshouser, Barbara A.; Deming, Douglas D.; Pearce, William J.; Sowers, Lawrence; Ashwal, Stephen.

In: Pediatric Research, Vol. 57, No. 6, 06.2005, p. 873-878.

Research output: Contribution to journalArticle

Angeles, DM, Wycliffe, N, Michelson, D, Holshouser, BA, Deming, DD, Pearce, WJ, Sowers, L & Ashwal, S 2005, 'Use of opioids in asphyxiated term neonates: Effects on neuroimaging and clinical outcome', Pediatric Research, vol. 57, no. 6, pp. 873-878. https://doi.org/10.1203/01.PDR.0000157676.45088.8C
Angeles DM, Wycliffe N, Michelson D, Holshouser BA, Deming DD, Pearce WJ et al. Use of opioids in asphyxiated term neonates: Effects on neuroimaging and clinical outcome. Pediatric Research. 2005 Jun;57(6):873-878. https://doi.org/10.1203/01.PDR.0000157676.45088.8C
Angeles, Danilyn M. ; Wycliffe, Nathaniel ; Michelson, David ; Holshouser, Barbara A. ; Deming, Douglas D. ; Pearce, William J. ; Sowers, Lawrence ; Ashwal, Stephen. / Use of opioids in asphyxiated term neonates : Effects on neuroimaging and clinical outcome. In: Pediatric Research. 2005 ; Vol. 57, No. 6. pp. 873-878.
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