Dexmedetomidine as an Adjunct to Fentanyl for Term Neonates on Mechanical Ventilation

Despite well conducted studies on pain management in mechanically ventilated neonates, there is still a need for exploration of appropriate and accurate pharmacological management strategies for this ongoing pain, and assessment of the clinical impact of the used drugs for analgesia and sedation. Opioids, such as fentanyl, are frequently used for analgesia and sedation in mechanically ventilated neonates with their short- and long-term adverse consequences Dexmedetomidine (DEX) is a specific alpha2 adrenergic agonist with promising data in NICU. Data exist that Dexmedetomidine recipient neonates require less adjunct sedation, experience less respiratory depression, less clinically significant hemodynamic effects, quicker establishment of enteral feeds and they could be extubated whilst on Dexmedetomidine infusion.

In the current study, the aim was to reduce fentanyl doses on mechanical ventilated neonates after adding Dexmedetomidine

Inclusion criteria

• Full term neonates (≥ 37 weeks gestational age)
• Age: 1 to 28 days.
• Neonates just started invasive mechanical ventilation and are going to start sedation.

Exclusion criteria

• Presence of central nervous system abnormality
• Complex multiple congenital anomalies
• Neonates with facial malformations
• Neonates on mechanical Ventilation setting (peep above 9)