ABSTRACT
BACKGROUND: Neonates undergoing surgery require analgesic medication to ameliorate acute pain. These medications produce negative side effects. Docosahexaenoic acid (DHA) has an antinociceptive effect in animals, but this has not been evaluated in human neonates. We evaluated the DHA effect on cumulative dose and duration of analgesics administered to neonates undergoing cardiovascular surgery. METHODS: A secondary analysis was performed with data from a clinical trial, in which enteral DHA was administered perioperatively compared with sunflower oil (SO). Present study assessed the antinociceptive effect of DHA by measuring the cumulative dose and duration of analgesics administered during postoperative stay in a neonatal intensive care unit. Multivariate linear regression models were performed. RESULTS: Seventeen neonates received DHA and 18 received SO in the control group. Compared with the control group, the DHA group received lower cumulative dose (14.6 ± 2.2 vs. 25.2 ± 4.8 µg/kg, p = 0.029) and shorter duration of buprenorphine (2 days (1-8) vs. 4.5 days (1-12); p = 0.053). After adjusting for confounders, the DHA group received significantly lesser buprenorphine (ß = -27 µg/kg, p = 0.028; R2 model = 0.90) for shorter duration (ß = -9 days, p = 0.003; R2 model = 0.94). No differences in fentanyl or ketorolac were detected. CONCLUSIONS: Buprenorphine administration was reduced in neonates who received DHA, suggesting that DHA likely has analgesic effects.
Subject(s)
Aorta/surgery , Blalock-Taussig Procedure/adverse effects , Cardiovascular Abnormalities/surgery , Dietary Supplements , Docosahexaenoic Acids/therapeutic use , Infant Nutritional Physiological Phenomena , Pain, Postoperative/prevention & control , Acute Pain/drug therapy , Acute Pain/prevention & control , Analgesics, Opioid/administration & dosage , Analgesics, Opioid/adverse effects , Analgesics, Opioid/therapeutic use , Anti-Inflammatory Agents, Non-Steroidal/adverse effects , Anti-Inflammatory Agents, Non-Steroidal/therapeutic use , Aorta/abnormalities , Buprenorphine/administration & dosage , Buprenorphine/adverse effects , Buprenorphine/therapeutic use , Dietary Supplements/adverse effects , Docosahexaenoic Acids/adverse effects , Double-Blind Method , Female , Follow-Up Studies , Hospitals, Pediatric , Humans , Infant, Newborn , Intensive Care Units, Neonatal , Male , Mexico , Pain, Postoperative/drug therapy , Perioperative Care/adverse effects , Time FactorsABSTRACT
A series of five cases with Wegener's granulomatosis (WG) is presented: two women and three men with an average age of 37 years old, with an average time of evolution of the disease of 5 years and systemic clinical presentation (respiratory, renal and ocular affection); the ANCA were positive; three of them were carriers of Staphylococcus aureus. All the patients received combined therapy composed by trimethoprim-sulfamethoxazole-cyclophosphamide (TMS-CFM) during approximately 29 months of follow- up, except for a pregnant patient. The patients showed a satisfactory clinical evolution with improvement of the manifestations of the disease. We suggest that, due to its benefits, the combination of TMS-CFM can be useful as a therapeutic alternative in WG.
