Opioids for neonates receiving mechanical ventilation.

Abstract:

BACKGROUND:Mechanical ventilation is a potentially painful and discomforting intervention widely used in neonatal intensive care units. Newborn babies (neonates) demonstrate increased sensitivity to pain, which may affect clinical and neurodevelopmental outcomes. The use of drugs that reduce pain might be important in improving survival and neurodevelopmental outcomes. OBJECTIVES:To determine the effect of opioid analgesics (pain-killing drugs derived from opium e.g. morphine), compared to placebo, no drug, or other non-opioid analgesics or sedatives, on pain, duration of mechanical ventilation, mortality, growth and neurodevelopmental outcomes in newborn infants on mechanical ventilation. SEARCH STRATEGY:Electronic searches included: the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, Issue 2, 2007); MEDLINE (1966 to June 2007); EMBASE (1974 to June 2007); and CINAHL (1982 to 2007). Previous reviews and lists of relevant articles were cross-referenced. SELECTION CRITERIA:Randomised controlled trials or quasi-randomised controlled trials comparing opioids to a control, or to other analgesics or sedatives in newborn infants on mechanical ventilation. DATA COLLECTION AND ANALYSIS:Data were extracted independently by two review authors. Categorical outcomes were analysed using relative risk and risk difference; and continuous outcomes with weighted mean difference or standardised mean difference. A fixed effect model was used for meta-analysis except where heterogeneity existed, in which case a random effects model was used. MAIN RESULTS:Thirteen studies on 1505 infants were included. Infants given opioids showed reduced premature infant pain profile (PIPP) scores compared to the control group (weighted mean difference -1.71; 95% confidence interval -3.18 to -0.24). Differences in execution and reporting of trials mean that this meta-analysis should be interpreted with caution. Heterogeneity was significantly high in all analyses of pain, even when lower quality studies were excluded and analysis limited to very preterm newborns. Meta-analyses of mortality, duration of mechanical ventilation, and long and short-term neurodevelopmental outcomes showed no statistically significant differences. Very preterm infants given morphine took significantly longer to reach full enteral feeding than those in control groups (weighted mean difference 2.10 days; 95% confidence interval 0.35 to 3.85). One study compared morphine with a sedative: the treatments showed similar pain scores, but morphine had fewer adverse effects. AUTHORS' CONCLUSIONS:There is insufficient evidence to recommend routine use of opioids in mechanically ventilated newborns. Opioids should be used selectively, when indicated by clinical judgment and evaluation of pain indicators. If sedation is required, morphine is safer than midazolam. Further research is needed.

authors

Bellù R,de Waal KA,Zanini R

doi

10.1002/14651858.CD004212.pub3

subject

Has Abstract

pub_date

2008-01-23 00:00:00

pages

CD004212

issue

1

issn

1469-493X

pub_type

杂志文章,meta分析,评审
  • Chromoscopy versus conventional endoscopy for the detection of polyps in the colon and rectum.

    abstract:BACKGROUND:Although conventional colonoscopy is the most sensitive test available for the investigation of the colorectum for polyps, there are data that raise concerns about its sensitivity. Chromoscopy may be one way of enhancing the ability for colonoscopy to detect polyps particularly diminutive flat lesions that m...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD006439.pub2

    authors: Brown SR,Baraza W,Hurlstone P

    更新日期:2007-10-17 00:00:00

  • Vaccines for preventing influenza in people with asthma.

    abstract:BACKGROUND:Influenza vaccination is recommended for asthmatic patients in many countries as observational studies have shown that influenza infection can be associated with asthma exacerbations, but influenza vaccination itself has the potential to adversely affect pulmonary function. A recent overview concluded that t...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD000364.pub2

    authors: Cates CJ,Jefferson TO,Bara AI,Rowe BH

    更新日期:2004-01-01 00:00:00

  • Adjuvant chemotherapy for invasive bladder cancer (individual patient data).

    abstract:BACKGROUND:Controversy exists as to whether adjuvant chemotherapy improves survival in patients with invasive bladder cancer, despite a number of randomised controlled trials. OBJECTIVES:To evaluate the effect of adjuvant chemotherapy in invasive bladder cancer. We conducted a systematic review and meta-analysis of up...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD006018

    authors: Advanced Bladder Cancer (ABC) Meta-analysis Collaboration.

    更新日期:2006-04-19 00:00:00

  • Anticoagulation for the initial treatment of venous thromboembolism in patients with cancer.

    abstract:BACKGROUND:Compared to patients without cancer, patients with cancer who receive anticoagulant treatment for venous thromboembolism are more likely to develop recurrent venous thromboembolism (VTE). OBJECTIVES:To compare the efficacy and safety of three types of parenteral anticoagulants for the initial treatment of V...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD006649.pub5

    authors: Akl EA,Vasireddi SR,Gunukula S,Barba M,Sperati F,Terrenato I,Muti P,Schünemann H

    更新日期:2011-06-15 00:00:00

  • Photodynamic therapy for recurrent respiratory papillomatosis.

    abstract:BACKGROUND:Recurrent respiratory papillomatosis (RRP) is a benign condition of the mucosa of the upper aerodigestive tract. It is characterised by recurrent papillomatous lesions and is associated with human papillomavirus (HPV). Frequent recurrence and rapid papilloma growth are common and in part responsible for the ...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD009810.pub2

    authors: Lieder A,Khan MK,Lippert BM

    更新日期:2014-06-05 00:00:00

  • Antibiotics for preterm premature rupture of membranes.

    abstract:BACKGROUND:The consequences of prematurity continue to result in neonatal morbidity and mortality. One of the causes of prematurity is preterm prelabour rupture of membranes in which there is evidence that subclinical infection plays a role. OBJECTIVES:The aim of the review was to evaluate the effectiveness and the im...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD001058

    authors: Kenyon S,Boulvain M,Neilson J

    更新日期:2001-01-01 00:00:00

  • Massage, reflexology and other manual methods for pain management in labour.

    abstract:BACKGROUND:Many women would like to avoid pharmacological or invasive methods of pain management in labour, and this may contribute towards the popularity of complementary methods of pain management. This review examined the evidence currently available on manual methods, including massage and reflexology, for pain man...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD009290.pub3

    authors: Smith CA,Levett KM,Collins CT,Dahlen HG,Ee CC,Suganuma M

    更新日期:2018-03-28 00:00:00

  • Combination injectable contraceptives for contraception.

    abstract:BACKGROUND:Combination injectable contraceptives (CICs) provide a highly effective, reversible method of preventing pregnancy, and they do not require daily administration or use at the time of coitus. Although they are used in many countries, their acceptability could be limited by method characteristics, such as the ...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:

    authors: Gallo MF,Grimes DA,Lopez LM,Schulz KF,d'Arcangues C

    更新日期:2013-01-01 00:00:00

  • Surgery for obesity.

    abstract:BACKGROUND:Bariatric (weight loss) surgery for obesity is considered when other treatments have failed. The effects of the available bariatric procedures compared with medical management and with each other are uncertain. This is an update of a Cochrane review first published in 2003 and previously updated in 2005. OB...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD003641.pub3

    authors: Colquitt JL,Picot J,Loveman E,Clegg AJ

    更新日期:2009-04-15 00:00:00

  • Whole brain radiation therapy (WBRT) alone versus WBRT and radiosurgery for the treatment of brain metastases.

    abstract:BACKGROUND:Historically, whole brain radiation therapy (WBRT) has been the main treatment for brain metastases. Stereotactic radiosurgery (SRS) delivers high-dose focused radiation and is being increasingly utilized to treat brain metastases. The benefit of adding SRS to WBRT is unclear. This is an updated version of t...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD006121.pub3

    authors: Patil CG,Pricola K,Sarmiento JM,Garg SK,Bryant A,Black KL

    更新日期:2012-09-12 00:00:00

  • Transcutaneous electric nerve stimulation (TENS) for cancer pain in adults.

    abstract:BACKGROUND:Cancer-related pain is complex and multi-dimensional but the mainstay of cancer pain management has predominately used a biomedical approach. There is a need for non-pharmacological and innovative approaches. Transcutaneous Electric Nerve Stimulation (TENS) may have a role for a significant number of patient...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD006276.pub2

    authors: Robb KA,Bennett MI,Johnson MI,Simpson KJ,Oxberry SG

    更新日期:2008-07-16 00:00:00

  • Amphotericin B lipid soluble formulations vs amphotericin B in cancer patients with neutropenia.

    abstract:BACKGROUND:Patients with cancer who are treated with chemotherapy or receive a bone marrow transplant have an increased risk of acquiring fungal infections. Such infections can be life-threatening. Antifungal drugs are therefore often given prophylactically to such patients, or when they have a fever. OBJECTIVES:To co...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD000969

    authors: Johansen HK,Gotzsche PC

    更新日期:2000-01-01 00:00:00

  • Antidepressants using active placebos.

    abstract:BACKGROUND:Although there is a consensus that antidepressants are effective in depression, placebo effects are also thought to be substantial. Side effects of antidepressants may reveal the identity of medication to participants or investigators and thus may bias the results of conventional trials using inert placebos....

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD003012

    authors: Moncrieff J,Wessely S,Hardy R

    更新日期:2001-01-01 00:00:00

  • WITHDRAWN: Proton pump inhibitor treatment for acute peptic ulcer bleeding.

    abstract:BACKGROUND:Randomised controlled trials (RCTs) evaluating the clinical effect of proton pump inhibitors (PPIs) in peptic ulcer (PU) bleeding yield conflicting results. OBJECTIVES:To evaluate the efficacy of PPIs in acute bleeding from PU using evidence from RCTs. SEARCH STRATEGY:We searched CENTRAL, The Cochrane Libr...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD002094.pub4

    authors: Leontiadis GI,Sharma VK,Howden CW

    更新日期:2010-05-12 00:00:00

  • Traditional Chinese Medicine herbs for stopping bleeding from haemorrhoids.

    abstract:BACKGROUND:Haemorrhoids is a common perianal disease, which often causes haematochezia. Besides a surgical operation or minimally invasive treatment, a variety of traditional Chinese medicinal herbs (TCMHs) have been used to treat bleeding haemorrhoids. OBJECTIVES:To assess the effectiveness of traditional Chinese med...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD006791.pub2

    authors: Gan T,Liu YD,Wang Y,Yang J

    更新日期:2010-10-06 00:00:00

  • Perioperative medications for preventing temporarily increased intraocular pressure after laser trabeculoplasty.

    abstract:BACKGROUND:Glaucoma is the international leading cause of irreversible blindness. Intraocular pressure (IOP) is the only currently known modifiable risk factor; it can be reduced by medications, incisional surgery, or laser trabeculoplasty (LTP). LTP reduces IOP by 25% to 30% from baseline, but early acute IOP elevatio...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD010746.pub2

    authors: Zhang L,Weizer JS,Musch DC

    更新日期:2017-02-23 00:00:00

  • Procalcitonin, C-reactive protein, and erythrocyte sedimentation rate for the diagnosis of acute pyelonephritis in children.

    abstract:BACKGROUND:In children with urinary tract infection (UTI), only those with pyelonephritis (and not cystitis) are at risk for developing long-term renal sequelae. If non-invasive biomarkers could accurately differentiate children with cystitis from children with pyelonephritis, treatment and follow-up could potentially ...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD009185.pub2

    authors: Shaikh N,Borrell JL,Evron J,Leeflang MM

    更新日期:2015-01-20 00:00:00

  • Moderate-term, low-dose corticosteroids for rheumatoid arthritis.

    abstract:OBJECTIVES:To perform a systematic review of low-dose corticosteroid efficacy in the moderate term for the treatment of rheumatoid arthritis (RA). SEARCH STRATEGY:We conducted a search in MEDLINE from 1966 to 1998, using the keywords "corticosteroids" and "rheumatoid arthritis". We also handsearched all issues of Arth...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD001158

    authors: Criswell LA,Saag KG,Sems KM,Welch V,Shea B,Wells G,Suarez-Almazor ME

    更新日期:2000-01-01 00:00:00

  • Hyperbaric oxygen therapy for thermal burns.

    abstract:BACKGROUND:Hyperbaric oxygen therapy (HBOT) consists of intermittently administering 100% oxygen at pressures greater than 1 atmosphere in a pressure vessel. This technology has been used to treat a variety of disease states and has been described as helping patients who have sustained burns. OBJECTIVES:The aim of thi...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD004727.pub2

    authors: Villanueva E,Bennett MH,Wasiak J,Lehm JP

    更新日期:2004-01-01 00:00:00

  • Directly observed therapy for treating tuberculosis.

    abstract:BACKGROUND:Up to half the people with tuberculosis do not complete their treatment. Thus strategies that improve adherence to treatment regimens are important. OBJECTIVES:To compare policies of directly observed therapy with self treatment at home in people requiring treatment for clinically active tuberculosis, or re...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD003343

    authors: Volmink J,Garner P

    更新日期:2003-01-01 00:00:00

  • Pit and fissure sealants for preventing dental decay in permanent teeth.

    abstract:BACKGROUND:Dental sealants were introduced in the 1960s to help prevent dental caries, mainly in the pits and fissures of occlusal tooth surfaces. Sealants act to prevent bacteria growth that can lead to dental decay. Evidence suggests that fissure sealants are effective in preventing caries in children and adolescents...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD001830.pub5

    authors: Ahovuo-Saloranta A,Forss H,Walsh T,Nordblad A,Mäkelä M,Worthington HV

    更新日期:2017-07-31 00:00:00

  • Alginate dressings for healing diabetic foot ulcers.

    abstract:BACKGROUND:Foot ulcers in people with diabetes mellitus are a common and serious global health issue. Dressings form a key part of ulcer treatment, with clinicians and patients having many different types to choose from including alginate dressings. A clear and current overview of current evidence is required to facili...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD009110.pub2

    authors: Dumville JC,O'Meara S,Deshpande S,Speak K

    更新日期:2012-02-15 00:00:00

  • Oral immunoglobulin for the treatment of rotavirus diarrhea in low birth weight infants.

    abstract:BACKGROUND:Rotavirus infection is the most common neonatal nosocomial viral infection. It is a major health problem worldwide. Epidemics with the newer P(6)G9 strains have been reported in neonatal units globally. These strains can cause severe symptoms in most infected infants. Infection control measures become necess...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD003742.pub2

    authors: Pammi M,Haque KN

    更新日期:2011-10-05 00:00:00

  • Acupuncture-point stimulation for chemotherapy-induced nausea or vomiting.

    abstract:BACKGROUND:There have been recent advances in chemotherapy-induced nausea and vomiting using 5-HT(3) inhibitors and dexamethasone. However, many still experience these symptoms, and expert panels encourage additional methods to reduce these symptoms. OBJECTIVES:The objective was to assess the effectiveness of acupunct...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD002285.pub2

    authors: Ezzo JM,Richardson MA,Vickers A,Allen C,Dibble SL,Issell BF,Lao L,Pearl M,Ramirez G,Roscoe J,Shen J,Shivnan JC,Streitberger K,Treish I,Zhang G

    更新日期:2006-04-19 00:00:00

  • Interventions to reduce weight gain in schizophrenia.

    abstract:BACKGROUND:Weight gain is common for people with schizophrenia and this has serious implications for health and well being. OBJECTIVES:To determine the effects of both pharmacological (excluding medication switching) and non pharmacological strategies for reducing or preventing weight gain in people with schizophrenia...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD005148.pub2

    authors: Faulkner G,Cohn T,Remington G

    更新日期:2007-01-24 00:00:00

  • Oxygen therapy for dyspnoea in adults.

    abstract:BACKGROUND:Dyspnoea, or distressing breathing, is often a severe subjective symptom in terminal illness and may be difficult to control. Oxygen therapy is currently one of the interventions used to treat it. This review aimed to identify all randomised controlled studies (RCTs) in which oxygen therapy was used as a tre...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD004769.pub2

    authors: Cranston JM,Crockett A,Currow D

    更新日期:2008-07-16 00:00:00

  • Surgical versus conservative interventions for treating fractures of the middle third of the clavicle.

    abstract:BACKGROUND:Clavicle fractures are common, accounting for 2.6% to 4% of all fractures. Eighty per cent of clavicle fractures are located in the middle third of the clavicle. Although treatment of these fractures is usually non-surgical, displaced clavicle fractures may be considered for surgical treatment because of the...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析

    doi:10.1002/14651858.CD009363.pub3

    authors: Lenza M,Buchbinder R,Johnston RV,Ferrari BA,Faloppa F

    更新日期:2019-01-22 00:00:00

  • Antithrombotic drugs for carotid artery dissection.

    abstract:BACKGROUND:Extracranial internal carotid artery dissection can lead to occlusion of the artery and hence cause an ischaemic stroke. It is the underlying stroke mechanism in approximately 2.5% of all strokes. It is the second leading cause of stroke in patients younger than 45 years of age. Anticoagulants or antiplatele...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD000255

    authors: Lyrer P,Engelter S

    更新日期:2003-01-01 00:00:00

  • Interventions for prevention and treatment of vulvovaginal candidiasis in women with HIV infection.

    abstract:BACKGROUND:Vulvovaginal candidiasis (VVC) is one of the most common fungal infections that recur frequently in HIV infected women. Symptoms of VVC are pruritis, discomfort, dyspareunia, and dysuria. Vulval infection presents as a morbiliform rash that may extend to the thighs. Vaginal infection is associated with white...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD008739.pub2

    authors: Ray A,Ray S,George AT,Swaminathan N

    更新日期:2011-08-10 00:00:00

  • Vitamin A and fish oils for retinitis pigmentosa.

    abstract:BACKGROUND:Retinitis pigmentosa (RP) comprises a group of hereditary eye diseases characterized by progressive degeneration of retinal photoreceptors. It results in severe visual loss that may lead to legal blindness. Symptoms may become manifest during childhood or adulthood, and include poor night vision (nyctalopia)...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD008428.pub2

    authors: Rayapudi S,Schwartz SG,Wang X,Chavis P

    更新日期:2013-12-19 00:00:00