{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T14:53:17Z","timestamp":1787237597543,"version":"build-2736575974"},"reference-count":29,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2023,3,19]],"date-time":"2023-03-19T00:00:00Z","timestamp":1679184000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["accpjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacotherapy"],"published-print":{"date-parts":[[2023,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Study Objective<\/jats:title>\n                    <jats:p>To describe the impact of protocol\u2010driven dexmedetomidine (and clonidine) use on opioid exposure in post\u2010surgical neonates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Retrospective chart review.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>A Level III, surgical NICU.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients<\/jats:title>\n                    <jats:p>Surgical neonates who received clonidine or dexmedetomidine concomitantly with an opioid for sedation and\/or analgesia post\u2010operatively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Intervention<\/jats:title>\n                    <jats:p>Implementation of a standardized sedation\/analgesia weaning protocol.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements and Main Results<\/jats:title>\n                    <jats:p>\n                      There were clinically, although not statistically, significant reductions in opioid wean duration (240 vs. 227\u2009h,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.82), total opioid duration (604 vs. 435\u2009h,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.23), and total opioid exposure (91 vs. 51\u2009mg ME\/kg,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.13), and limited impact on NICU outcomes or pain\/withdrawal scores with use of the protocol. Increases in use of medications in alignment with the protocol (e.g., scheduled acetaminophen and opioids weaned first) were noted.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>We have been unable to demonstrate a reduction in opioid exposure with use of alpha\u20102 agonists alone; addition of a weaning protocol showed a reduction in opioid duration and exposure (although not statistically significant). At this point, dexmedetomidine and clonidine should not be introduced outside standardized protocols with scheduled acetaminophen post\u2010operatively.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/phar.2787","type":"journal-article","created":{"date-parts":[[2023,3,2]],"date-time":"2023-03-02T09:25:31Z","timestamp":1677749131000},"page":"632-637","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Impact of dexmedetomidine in conjunction with a weaning protocol on post\u2010surgical opioid use in a neonatal intensive care unit"],"prefix":"10.1002","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5345-444X","authenticated-orcid":false,"given":"Deonne","family":"Dersch\u2010Mills","sequence":"first","affiliation":[{"name":"Alberta Health Services, Pharmacy Services  Calgary Alberta Canada"},{"name":"Alberta Children's Hospital, Neonatal Intensive Care Unit  Calgary Alberta 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