Newborns may require methadone after surgery, but its use presents challenges.

Newborns may require methadone after surgery, but its use presents challenges.

The Impact of Opioid Use on Newborns Undergoing Surgery for Life-Threatening Bowel Infection

When it comes to newborns undergoing surgery to treat life-threatening bowel infections, about 1 in 5 are given opioids for pain relief, and some eventually require methadone to wean them off these addictive drugs. However, a new study has revealed that there is significant variability in the use of opioids after surgery in infants, with the babies who need methadone experiencing a longer hospital stay.

Dr. Lorraine Kelley-Quon, a pediatric surgeon at Children’s Hospital Los Angeles and co-author of the study, shared, “Nobody wants a baby to be in pain. We don’t want to stop using opioids, especially when a baby is undergoing an operation. What we do want is to understand the impact of opioids and use them more judiciously.” Unfortunately, infants cannot take nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen for pain relief, as older children can.

The study focused on how the use of methadone affected recovery in infants who underwent surgery for a life-threatening inflammatory condition called necrotizing enterocolitis (NEC), which primarily affects premature infants. NEC is rare but is the most common reason for emergency surgery in newborns.

Examining data from over 2,000 babies treated at 48 children’s hospitals across the United States, researchers found that babies who required methadone had to stay in the hospital for an average of 21 days longer after surgery. This group also needed more days on the ventilator and a longer reliance on intravenous nutrition.

“It ends up being a snowball effect,” explained Dr. Kelley-Quon. “The longer a baby is on opioids, the more likely the need for methadone, which is still an opioid.” Therefore, standardizing opioid use may help address this issue, as there was a significant variation in the use of methadone among different hospitals.

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The study’s findings shed light on the importance of understanding and managing pain relief for newborns. “If you abruptly stop opioids in babies, they can show signs of withdrawal such as irritability, intestinal problems, or even seizures,” added Dr. Kelley-Quon. To relieve withdrawal symptoms, methadone is used as a longer-acting, weaker opioid. However, prolonged opioid use has its own set of challenges, leading to an extended hospital stay and increased dependence on medical interventions.

The study highlights the need for healthcare providers to carefully consider the use and dosage of opioids in newborns, seeking to strike a delicate balance between relieving pain and managing potential complications. Greater awareness and education on alternative pain management methods specific to newborns is also crucial to minimize opioid use and its subsequent effects.

Standardizing the use of opioids in the treatment of NEC could be a step towards ensuring consistent and appropriate pain management for newborns. Dr. Kelley-Quon noted the wide range of variability among hospitals, with some utilizing methadone in over 40% of cases while others do not use it at all. Understanding best practices and effective pain management strategies could help reduce the risks associated with opioid use in infants.

In conclusion, newborns undergoing surgery for life-threatening bowel infections often require opioids for pain relief, and some may need methadone to taper off these opioids. However, the study emphasizes the importance of judicious use of opioids in order to prevent prolonged hospital stays and increased reliance on medical interventions. Standardizing the use of opioids, along with greater awareness and education around pain management in newborns, can contribute to improved outcomes and reduced morbidity in this vulnerable population.

Question: Newborn babies don’t sleep very much.