Opioids and alpha-2-agonists for analgesia and sedation in newborn infants: protocol of a systematic review
Abstract Background Hospitalized newborn infants may require analgesia and sedation either for the management of procedural pain, during or after surgery, and other painful conditions. The benefits and harms of opioids administered at different doses and routes of administration have been reported i...
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| Format: | Article |
| Language: | English |
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BMC
2020-08-01
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| Series: | Systematic Reviews |
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| Online Access: | http://link.springer.com/article/10.1186/s13643-020-01436-0 |
| _version_ | 1818249522303729664 |
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| author | Mari Kinoshita Katarzyna Stempel Israel Junior Borges do Nascimento Dhashini Naidu Vejayaram Elisabeth Norman Matteo Bruschettini |
| author_facet | Mari Kinoshita Katarzyna Stempel Israel Junior Borges do Nascimento Dhashini Naidu Vejayaram Elisabeth Norman Matteo Bruschettini |
| author_sort | Mari Kinoshita |
| collection | DOAJ |
| description | Abstract Background Hospitalized newborn infants may require analgesia and sedation either for the management of procedural pain, during or after surgery, and other painful conditions. The benefits and harms of opioids administered at different doses and routes of administration have been reported in numerous trials and systematic reviews. The use of alpha-2-agonists such as clonidine and dexmedetomidine in newborn infants is more recent, and they might be prescribed to reduce the total amount of opioids which are thought to have more side effects. Moreover, alpha-2-agonists might play an important role in the management of agitation and discomfort. Methods We will conduct a systematic review and meta-analysis on the use of opioids, alpha-2-agonists, or the combination of both drugs. We will include randomized controlled trials to assess benefits and harms and observational studies to assess adverse events and pharmacokinetics; preterm and term infants; studies on any opioids or alpha-2-agonists administered for any indication and by any route except spinal, intraosseous, or administration for nerve blocks and wound infusions. The use of opioids or alpha-2-agonists will be compared to no intervention; placebo with normal saline or other non-sedative, non-analgesic drug; control with oral sugar solution or non-pharmacological intervention; same drug of different dose or route; or a different drug (not limiting to opioids and alpha-2-agonists) or combinations of such drugs. The primary outcomes for this review will be all-cause mortality during initial hospitalization and hypotension requiring medical therapy. We will conduct a search in the following databases: The Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library), MEDLINE, Embase, and CINAHL. Two review authors will independently screen records for inclusion, undertake data abstraction using a data extraction form and assess the risk of bias of all included trials using the Cochrane “Risk of bias” tool. Discussion This systematic review will summarize and update our knowledge about neonatal analgesia and sedation including pharmacokinetics/pharmacodynamics, and provide a platform for developing evidence-based guidelines that we can immediately apply to our clinical practice. Systematic review registration PROSPERO 2020 CRD42020170852 |
| first_indexed | 2024-12-12T15:37:50Z |
| format | Article |
| id | doaj.art-d3b159470156466ea70550967bf7158c |
| institution | Directory Open Access Journal |
| issn | 2046-4053 |
| language | English |
| last_indexed | 2024-12-12T15:37:50Z |
| publishDate | 2020-08-01 |
| publisher | BMC |
| record_format | Article |
| series | Systematic Reviews |
| spelling | doaj.art-d3b159470156466ea70550967bf7158c2022-12-22T00:19:58ZengBMCSystematic Reviews2046-40532020-08-01911810.1186/s13643-020-01436-0Opioids and alpha-2-agonists for analgesia and sedation in newborn infants: protocol of a systematic reviewMari Kinoshita0Katarzyna Stempel1Israel Junior Borges do Nascimento2Dhashini Naidu Vejayaram3Elisabeth Norman4Matteo Bruschettini5Faculty of Medicine, Lund UniversityFaculty of Medicine, Lund UniversitySchool of Medicine at Universidade Federal de Minas GeraisFaculty of Medicine, Lund UniversityLund University, Skane University Hospital, Department of Clinical Sciences Lund, PediatricsCochrane Sweden, Skåne University HospitalAbstract Background Hospitalized newborn infants may require analgesia and sedation either for the management of procedural pain, during or after surgery, and other painful conditions. The benefits and harms of opioids administered at different doses and routes of administration have been reported in numerous trials and systematic reviews. The use of alpha-2-agonists such as clonidine and dexmedetomidine in newborn infants is more recent, and they might be prescribed to reduce the total amount of opioids which are thought to have more side effects. Moreover, alpha-2-agonists might play an important role in the management of agitation and discomfort. Methods We will conduct a systematic review and meta-analysis on the use of opioids, alpha-2-agonists, or the combination of both drugs. We will include randomized controlled trials to assess benefits and harms and observational studies to assess adverse events and pharmacokinetics; preterm and term infants; studies on any opioids or alpha-2-agonists administered for any indication and by any route except spinal, intraosseous, or administration for nerve blocks and wound infusions. The use of opioids or alpha-2-agonists will be compared to no intervention; placebo with normal saline or other non-sedative, non-analgesic drug; control with oral sugar solution or non-pharmacological intervention; same drug of different dose or route; or a different drug (not limiting to opioids and alpha-2-agonists) or combinations of such drugs. The primary outcomes for this review will be all-cause mortality during initial hospitalization and hypotension requiring medical therapy. We will conduct a search in the following databases: The Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library), MEDLINE, Embase, and CINAHL. Two review authors will independently screen records for inclusion, undertake data abstraction using a data extraction form and assess the risk of bias of all included trials using the Cochrane “Risk of bias” tool. Discussion This systematic review will summarize and update our knowledge about neonatal analgesia and sedation including pharmacokinetics/pharmacodynamics, and provide a platform for developing evidence-based guidelines that we can immediately apply to our clinical practice. Systematic review registration PROSPERO 2020 CRD42020170852http://link.springer.com/article/10.1186/s13643-020-01436-0OpioidsAlpha-2-agonistsNeonateSedationAnalgesiaClonidine |
| spellingShingle | Mari Kinoshita Katarzyna Stempel Israel Junior Borges do Nascimento Dhashini Naidu Vejayaram Elisabeth Norman Matteo Bruschettini Opioids and alpha-2-agonists for analgesia and sedation in newborn infants: protocol of a systematic review Systematic Reviews Opioids Alpha-2-agonists Neonate Sedation Analgesia Clonidine |
| title | Opioids and alpha-2-agonists for analgesia and sedation in newborn infants: protocol of a systematic review |
| title_full | Opioids and alpha-2-agonists for analgesia and sedation in newborn infants: protocol of a systematic review |
| title_fullStr | Opioids and alpha-2-agonists for analgesia and sedation in newborn infants: protocol of a systematic review |
| title_full_unstemmed | Opioids and alpha-2-agonists for analgesia and sedation in newborn infants: protocol of a systematic review |
| title_short | Opioids and alpha-2-agonists for analgesia and sedation in newborn infants: protocol of a systematic review |
| title_sort | opioids and alpha 2 agonists for analgesia and sedation in newborn infants protocol of a systematic review |
| topic | Opioids Alpha-2-agonists Neonate Sedation Analgesia Clonidine |
| url | http://link.springer.com/article/10.1186/s13643-020-01436-0 |
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