EFFECTS OF FENTANYL ADMINISTRATION ON GENERAL AND CEREBRAL HEMODYNAMICS IN SICK NEWBORN-INFANTS

Despite the wide use of fentanyl for analgesia in newborns, concerns h ave been raised about potential haemodynamic side-effects. Since sick newborns may lose their cerebral blood flow autoregulation, a drug-ind uced haemodynamic instability could lead to brain injury. We assessed the effects of a 15-min infusion of fentanyl (3 mu g/kg) on the genera l and cerebral haemodynamics in 15 newborns (median gestational age 29 weeks, 25th-75th percentile, range 28-31 weeks; birthweight 1170 g, r ange 955-1790 g). The heart rate and mean arterial blood pressure were continuously recorded. Mean cerebral blood flow velocity and pulsatil ity index were measured using pulsed Doppler ultrasound before, during and up to 60 min after the onset of fentanyl administration. No signi ficant modification of general or cerebral haemodynamics was observed. In conclusion, the infusion of 3 mu g/kg of fentanyl did not lead to any deleterious effect on the general or cerebral haemodynamics in sic k normovolaemic newborns.