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A prospective evaluation of opioid weaning in opioid-dependent pediatric critical care patients. Anesth Analg 2006 Apr;102(4):1045-50

Date

03/23/2006

Pubmed ID

16551896

DOI

10.1213/01.ane.0000202395.94542.3e

Abstract

Critically ill children are treated with opioid medication in an attempt to decrease stress and alleviate pain during prolonged pediatric intensive care. This treatment plan places children at risk for opioid dependency. Once dependent, children need to be weaned or risk development of a withdrawal syndrome on abrupt cessation of medication. We enrolled opioid-dependent children into a prospective, randomized trial of 5- versus 10-day opioid weaning using oral methadone. Children exposed to opioids for an average of 3 wk showed no difference in the number of agitation events requiring opioid rescue (3 consecutive neonatal abstinence scores >8 every 2 h) in either wean group. Most of the events requiring rescue occurred on day 5 and 6 of the wean in both treatment groups. Patients may be able to be weaned successfully in 5 days once converted to oral methadone, with a follow-up period after medication wean to observe for a delayed withdrawal syndrome.

Author List

Berens RJ, Meyer MT, Mikhailov TA, Colpaert KD, Czarnecki ML, Ghanayem NS, Hoffman GM, Soetenga DJ, Nelson TJ, Weisman SJ

Authors

Richard J. Berens MD Professor in the Anesthesiology department at Medical College of Wisconsin
George M. Hoffman MD Chief, Professor in the Anesthesiology department at Medical College of Wisconsin
Theresa A. Mikhailov MD, PhD Professor in the Pediatrics department at Medical College of Wisconsin
Steven J. Weisman MD Professor in the Anesthesiology department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Analgesics, Opioid
Child, Preschool
Critical Care
Double-Blind Method
Female
Humans
Infant
Male
Opioid-Related Disorders
Pain
Prospective Studies
Substance Withdrawal Syndrome
jenkins-FCD Prod-444 eb4ebd1a08581aba961d3befd3b851a3c3ec6b46