Opioid and benzodiazepine use during therapeutic hypothermia in encephalopathic neonates

ABSTRACT OBJECTIVES To evaluate the use of sedatives and analgesics during therapeutic hypothermia in encephalopathic neonates and assess associations between medication exposure and

hospital outcomes. STUDY DESIGN We identified neonates ≥35 weeks gestational age treated with therapeutic hypothermia at 125 neonatal intensive care units between 2007 and 2015. We compared

characteristics and hospital outcomes between unexposed neonates and neonates exposed to opioids and/or benzodiazepines. RESULTS Opioids were administered to 1 677/2 621 (64%) neonates, and

exposure increased from 38% in 2008 to 68% in 2015. Sedation/analgesia varied widely between centers. Opioid-exposed neonates experienced greater durations of respiratory support and were

more likely to receive inotropes and inhaled nitric oxide. Mortality during postnatal days 0–3 was lower among opioid-exposed neonates (31/625 [5%]) than unexposed neonates (64/714 [9%]).

CONCLUSIONS Sedation/analgesia during therapeutic hypothermia is prevalent but not uniform across centers. Prospective studies are needed to assess if exposure independently predicts

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subscriptions * Read our FAQs * Contact customer support SIMILAR CONTENT BEING VIEWED BY OTHERS OPIOID EXPOSURE DURING THERAPEUTIC HYPOTHERMIA AND SHORT-TERM OUTCOMES IN NEONATAL

ENCEPHALOPATHY Article 26 April 2022 DEXMEDETOMIDINE VERSUS INTERMITTENT MORPHINE FOR SEDATION OF NEONATES WITH ENCEPHALOPATHY UNDERGOING THERAPEUTIC HYPOTHERMIA Article 01 March 2021

ASSOCIATION BETWEEN EARLY-PHASE OPIOID USE AND OUTCOMES IN EXTREMELY PRETERM INFANTS: A NATIONWIDE STUDY Article Open access 18 March 2025 REFERENCES * Lee ACC, Kozuki N, Blencowe H, Vos T,

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2018; https://doi.org/10.1038/s41372-018-0126-7. Article  PubMed  PubMed Central  Google Scholar  Download references FUNDING Our manuscript represents original work, is not under

consideration for publication elsewhere, and has not been previously published, except in abstract form at the Pediatric Academic Societies annual meetings in 2017 (between center variation)

and 2018 (outcome comparisons). This study was not financially supported or sponsored. MWB composed the first draft of the manuscript. No honorarium, grant, or other form of payment was

provided to any author in exchange for producing the manuscript. AUTHOR INFORMATION AUTHORS AND AFFILIATIONS * Department of Pediatrics, University of Wisconsin School of Medicine and Public

Health, Madison, WI, USA Megan W. Berube * Department of Pediatrics, Duke University, Durham, NC, USA Megan W. Berube, Monica E. Lemmon, Carolyn E. Pizoli, Margarita Bidegain, C. Michael

Cotten & Rachel G. Greenberg * Duke-Margolis Center for Health Policy, Durham, NC, USA Monica E. Lemmon * Johns Hopkins Hospital, Baltimore, MD, USA Monica E. Lemmon * Center for

Research, Education, Quality and Safety, MEDNAX Inc, Sunrise, FL, USA Veeral N. Tolia * Duke Clinical Research Institute, Durham, NC, USA Rachel G. Greenberg Authors * Megan W. Berube View

author publications You can also search for this author inPubMed Google Scholar * Monica E. Lemmon View author publications You can also search for this author inPubMed Google Scholar *

Carolyn E. Pizoli View author publications You can also search for this author inPubMed Google Scholar * Margarita Bidegain View author publications You can also search for this author

inPubMed Google Scholar * Veeral N. Tolia View author publications You can also search for this author inPubMed Google Scholar * C. Michael Cotten View author publications You can also

search for this author inPubMed Google Scholar * Rachel G. Greenberg View author publications You can also search for this author inPubMed Google Scholar CORRESPONDING AUTHOR Correspondence

to Megan W. Berube. ETHICS DECLARATIONS CONFLICT OF INTEREST RCG has received support from industry for research services (https://dcri.org/about-us/conflict-of-interest/). MEL receives

funding from the National Institute of Neurological Disorders and Stroke of the National Institutes of Health (K12NS098482) and the Derfner Foundation. CMC receives funding for work related

to interventions for hypoxic-ischemic encephalopathy from the Eunice Kennedy Shriver NICHD Neonatal Research Network Grant: 5U10 HD040492-10, and the Duke National Center for Advancing

Translational Sciences (NCATS) 1UL1-TR002553. MWB, MB, CEP, and VNT declare that they have no conflict of interest. ADDITIONAL INFORMATION PUBLISHER’S NOTE Springer Nature remains neutral

with regard to jurisdictional claims in published maps and institutional affiliations. RIGHTS AND PERMISSIONS Reprints and permissions ABOUT THIS ARTICLE CITE THIS ARTICLE Berube, M.W.,

Lemmon, M.E., Pizoli, C.E. _et al._ Opioid and benzodiazepine use during therapeutic hypothermia in encephalopathic neonates. _J Perinatol_ 40, 79–88 (2020).

https://doi.org/10.1038/s41372-019-0533-4 Download citation * Received: 13 June 2019 * Revised: 26 September 2019 * Accepted: 30 September 2019 * Published: 15 October 2019 * Issue Date:

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