Effect of oral naloxone hydrochloride on gastrointestinal transit in premature infants treated with morphine

  1. Ranaa Akkawi1,2,
  2. Staffan Eksborg1,3,
  3. Åsa Andersson1,
  4. Stefan Lundeberg4,
  5. Marco Bartocci5

Article first published online: 1 DEC 2008

DOI: 10.1111/j.1651-2227.2008.01128.x

Issue

Acta Paediatrica

Acta Paediatrica

Volume 98, Issue 3, pages 442–447, March 2009

Additional Information

How to Cite

Akkawi, R., Eksborg, S., Andersson, Å., Lundeberg, S. and Bartocci, M. (2009), Effect of oral naloxone hydrochloride on gastrointestinal transit in premature infants treated with morphine. Acta Paediatrica, 98: 442–447. doi: 10.1111/j.1651-2227.2008.01128.x

Author Information

  1. 1

    Karolinska Pharmacy, Karolinska University Hospital, Stockholm, Sweden

  2. 2

    Department of Pharmaceutical Biosciences, Division of Pharmacokinetics and Drug therapy, Faculty of Pharmacy, Uppsala University, Uppsala, Sweden

  3. 3

    Childhood Cancer Research Unit, Department of Woman and Child Health, Karolinska Institutet, Stockholm, Sweden

  4. 4

    Department of anaesthesiology, Unit for Paediatric Pain Treatment, Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden

  5. 5

    Department of Women and Child Health, Neonatal Intensive Care and Research Units, Astrid Lindgren Children's Hospital, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden

*Correspondence Marco Bartocci, Neonatal Intensive Care and Research Units, Astrid Lindgren Children's Hospital, Q2:07, Karolinska University Hospital, SE-171 76 Stockholm, Sweden. Tel: +46 8 51777354 | Fax: +46 8 51777353 | Email: marco.bartocci@ki.se

Publication History

  1. Issue published online: 29 JAN 2009
  2. Article first published online: 1 DEC 2008
  3. Received 29 April 2008; revised 26 September 2008; accepted 16 October 2008.

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Keywords:

  • Constipation;
  • Enteral nutrition;
  • Gastrointestinal motility;
  • Morphine;
  • Naloxone;
  • Newborn premature infant;
  • Pain

Abstract

Background: Opioids are common drugs for pain treatment in preterm newborn infants, in spite of several adverse effects. Constipation is a frequent problem when opioids are used in both adults and neonates. Although several studies indicate that the oral administration of naloxone hydrochloride (NH) improves intestinal motility during opioid therapy, there is still a lack of evidence in newborns.

Aim: The aim of this study was to assess the efficacy of NH against reduced intestinal motility during opioid treatment.

Methods: A retrospective cohort study was performed. We analysed the medical records of fifteen infants (Group 1) treated with continuous morphine (MO) infusion and fourteen infants (Group 2) treated with both oral NH (3 μg/kg 4 times daily) and MO.

Results: There was no statistically significant difference in the total MO dose. Infants treated both with NH and MO had a tendency to improve their mean stool frequency/day. A statistically significant improvement was observed in the mean total food intake (mL/kg/day) of the infants treated with NH (p = 0.014). No difference in the mean food retention between the two groups was observed.

Conclusion: Orally administrated NH seems to improve intestinal motility resulting in increased food intake/day and improved stool frequency/day in premature newborn infants treated with MO. Further studies are needed to corroborate these findings.

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