Hazards of pentazocine for neonatal analgesia: a single-centre experience over 10 years.

Abstract

BACKGROUND:

In developing countries, neonatal analgesia for surgical procedures is a major challenge where postoperative care is inadequate.

AIM:

To report experience of pentazocine for neonatal surgery in a Nigerian tertiary hospital.

METHODS:

A retrospective study of surgical neonates who received pentazocine at the University of Benin Teaching Hospital in Benin City between January 1998 and December 2007.

RESULTS:

During the period, 2590 paediatric operations were performed including 368 (14.2%) neonates, 49 (13.3%) of whom had pentazocine. The other neonates received a variety of analgesics. Of 56 neonates who developed respiratory depression, 40 (71.4%) had pentazocine (p<0.0001). Fifteen (30.6%) neonates aged between 9 hours and 28 days [mean (SD) 12 (1.2) days] died between 1 and 36 hours following 8-hourly administration of 0.5 mg/kg pentazocine. In older children who had pentazocine, over-sedation was also a problem but there were no deaths. Deaths in neonates were mainly owing to persistent respiratory depression which was compounded by the unavailability of a paediatric ventilator. However, many neonates responded to naloxone. All neonates who died had an autopsy and no lesion was found which could have compromised respiratory function.

CONCLUSION:

The use of pentazocine in neonates was associated with high morbidity and mortality. Caution is required when using pentazocine for neonatal analgesia where post-operative respiratory support is insufficient.

• Authors: O D Osifo, S E Aghahowa
• Journal: Annals of tropical paediatrics (Ann Trop Paediatr) Vol. 28 Issue 3 Pg. 205-10 (Sep 2008) ISSN: 0272-4936 [Print] England
• PMID: 18727849 (Publication Type: Journal Article)

Chemical References

• Analgesics, Opioid
• Pentazocine

Topics

• Analgesia (adverse effects, methods)
• Analgesics, Opioid (adverse effects)
• Developing Countries
• Female
• Humans
• Infant, Newborn
• Male
• Nigeria
• Pain, Postoperative (prevention & control)
• Pentazocine (adverse effects)
• Postoperative Complications
• Respiratory Insufficiency (chemically induced)
• Retrospective Studies