Journal of the Korean Pediatric Society 1999;42(5):657-665.
Published online May 15, 1999.
Pain Reduction Effects of Continuous Fentanyl Infusion to Intensive Care Neonates
Wi Kyung Hwang, Heng Mi Kim
Department of Pediatrics, School of Medicine, Kyungpook University, Taegu, Korea
신생아 집중치료실 입원아에서 Fentanyl 투여가 통증 반응에 미치는 영향
황위경, 김행미
경북대학교 의과대학 소아과학교실
Correspondence: 
Wi Kyung Hwang, Email: 1
Abstract
Purpose
: To determine whether pain control using fentanyl would effectively reduce behavioral distress, physiologic and hormonal responses to postoperative pain and mechanical ventilation in neonates.
Methods
: Neonates who were admitted to the NICU(neonate intensive care unit) of Kyungpook University Hospital, requiring surgery or mechanical ventilation were evaluated. Twelve neonates undergoing operation were randomised into two groups. After operation, one group received fentanyl and the other was given saline. Behavioral distress using postoperative comfort scores, heart rate, blood pressure and blood glucose were evaluated before and after operation. Cortisol concentration and beta endorphin were measured before and at the end of operation and at 60 minutes after fentanyl infusion. The values were compared between the two groups. In eight neonates on mechanical ventilation, behavioral distress using pain scores, heart rate, blood pressure, oxygen saturation and concentrations of cortisol and beta endorphin were measured before and 60 minutes after fentanyl infusion.
Results
: In neonates undergoing surgery, fentanyl infusion diminished the elevation of post operation heart rate and blood glucose(P<0.05) and induced the improvement of postoperation comfort scores(P<0.05). Cortisol levels were significantly lower in neonates receiving fentanyl(P< 0.01) at 60min after infusion. In neonates on mechanical ventilaion, fentanyl infusion diminished the elevation of systolic blood pressure and heart rate on endotracheal suction(P<0.05). At 60 minutes after infusion, cortisol levels were markedly lower in neonates receiving fentanyl(P<0.05).
Conclusion
: Neonates feel pain during postoperation and on mechanical ventilation. As fentanyl therapy appears to be effective in controlling the pain, anaesthetic agents should be given to all neonates undergoing painful procedures or under painful situations.
Key Words: Pain, Fentanyl, Mechanical ventilation, Surgery


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