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An assessment of dexmedetomidine as an opioid-sparing agent after neonatal open thoracic and abdominal operations

Journal of Perinatology volume 42, pages 307–312 (2022)Cite this article

Subjects

Abstract

Objective

To evaluate the efficacy of dexmedetomidine as an opioid-sparing agent in infants following open thoracic or abdominal operations.

Methods

Retrospective review of postoperative neonates who received IV acetaminophen with or without dexmedetomidine. The primary outcome was opioid dosage within the first ten postoperative days. Secondary outcomes included times to extubation, full feedings and discharge.

Results

112 infants met inclusion criteria. Those managed with dexmedetomidine received 1.8–4.3 times more opioid on postoperative days 1–3, had longer times to extubation and trended towards longer lengths of hospital stay than infants who were not. Opioid was dosed >0.2 ME/kg on only 23% of days when the acetaminophen dose was >40 mg/kg/day and 10% of days when the acetaminophen dose was >45 mg/kg.

Conclusion

Dexmedetomidine may not be opioid sparing after major operations in neonates and its use delays recovery. IV acetaminophen dosed at 40 mg/kg/day or greater may yield the most substantial opioid-sparing effect.

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Funding

There was no external or internal institutional funding support for this study.

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Authors and Affiliations

  1. Rady Children’s Hospital, San Diego, CA, USA

    Alicia G. Sykes & Gerald Gollin

  2. University of California San Diego School of Medicine, San Diego, CA, USA

    Parisa Oviedo

  3. Scripps Mercy Hospital, San Diego, CA, USA

    Alexandra S. Rooney

Authors
  1. Alicia G. Sykes
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  2. Parisa Oviedo
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  3. Alexandra S. Rooney
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  4. Gerald Gollin
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Contributions

AS and GG conceived and designed the project; AS, PO and GG collected the data; AS, AR, PO and GG performed the data analysis; AS, PO and GG contributed to writing the manuscript.

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Correspondence to Gerald Gollin.

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The authors declare no competing interests.

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Sykes, A.G., Oviedo, P., Rooney, A.S. et al. An assessment of dexmedetomidine as an opioid-sparing agent after neonatal open thoracic and abdominal operations. J Perinatol 42, 307–312 (2022). https://doi.org/10.1038/s41372-021-01175-7

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