Evaluating patterns of morphine use in a neonatal intensive care unit after NEOPAIN

J Neonatal Perinatal Med. 2013 Jan 1;6(4):333-8. doi: 10.3233/NPM-1371513.

Abstract

Objective: To test the hypothesis that use of morphine for sedation of ventilated premature neonates has not changed despite evidence-based recommendations.

Study design: Retrospective chart review.

Results: Of 410 ventilated patients, 129 received a morphine infusion. The annual percentage of ventilated patients started on an infusion did not vary significantly from 2005-2010 (range: 27%-37%, mean: 32%, χ2 test for trend p = 0.60). Patients given morphine infusion had a lower median estimated gestational age at birth (26 0/7 weeks versus 27 6/7 weeks), and a lower median birth weight (762 versus 1010 grams).

Conclusion: Use of morphine as a sedative and/or pre-emptive analgesic agent for critically ill, ventilated, premature neonates has not decreased at the study site despite evidence-based recommendations against this treatment approach. This is an area of care that may benefit from quality improvement interventions.

Keywords: Neonatal pain; opiate; sedation.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Analgesics, Opioid / administration & dosage*
  • Birth Weight
  • Evidence-Based Medicine
  • Female
  • Gestational Age
  • Humans
  • Infant, Newborn
  • Infant, Premature
  • Infusions, Intravenous
  • Intensive Care Units, Neonatal / statistics & numerical data*
  • Male
  • Morphine / administration & dosage*
  • Respiration, Artificial / methods*
  • Retrospective Studies
  • Risk Factors

Substances

  • Analgesics, Opioid
  • Morphine