RANDOMIZED CONTROLLED TRIAL OF LOW-DOSE FENTANYL INFUSION IN PRETERM INFANTS WITH HYALINE-MEMBRANE DISEASE

Aim-To evaluate the effects of low dose fentanyl infusion analgesia on behavioural and neuroendocrine stress response and short term, outcom e in premature infants ventilated for hyaline membrane disease. Method s-Twenty seven ventilated preterm infants were randomly assigned to re ceive a mean fentanyl infusion of 1.1 (0.08 SE) mu g/kg/h for 75 (5) h ours, and 28 untreated infants were considered a control group. A beha vioural sedation score was used to assess the infants' behaviour. Urin ary metanephrine and the nob metanephrine:creatinine molar ratio were determined at 0, 24, 48 and 72 hours. Outcome data and ventilatory ind exes were recorded for each infant. Results-The fentanyl group showed significantly lower behavioural stress scares and 0, desaturations tha n controls and lower urinary concentrations of metanephrine and normet anephrine at 24, 48, 72 hours. The two groups showed no significant di fference in ventilatory variables or short term outcome. Conclusions-A short course of low dose fentanyl infusion reduces behavioural sedati on scores, 0, desaturations and neuroendocrine stress response in pret erm ventilated infants.