{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T03:08:39Z","timestamp":1777432119584,"version":"3.51.4"},"reference-count":17,"publisher":"The Pediatric Pharmacy Association","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019]]},"abstract":"<jats:p>\n          <jats:bold>BACKGROUND<\/jats:bold> Opioids and benzodiazepines have been the mainstay of neonatal analgesia and sedation. However, based on evidence in neonatal animals, these drugs may be deleterious for the developing brain. Dexmedetomidine (DEX), a central alpha-2 agonist, has sedative and analgesic effects and has been shown to be neuroprotective in animal models. Despite increasing use of DEX in newborns, there is a paucity of data regarding its safety and efficacy in this population.<\/jats:p>\n        <jats:p>\n          <jats:bold>OBJECTIVES<\/jats:bold> The impact of using DEX in postsurgical neonates, either alone or with opioid infusions, for sedation\/analgesia was evaluated. The cumulative dose of opioids among patients who did or did not receive DEX was calculated to examine the hypothesis that the addition of DEX can reduce the patient exposure to opioids without significantly increasing side effects and providing adequate sedation and pain control.<\/jats:p>\n        <jats:p>\n          <jats:bold>METHODOLOGY<\/jats:bold> This was a retrospective cohort study in which patients were matched by postnatal age and surgical procedure into 2 groups. One group received DEX in the regimen for treatment of pain or sedation after a surgical procedure, and the other group received no DEX. Episodes of bradycardia, respiratory depression and hypotension, and the cumulative dose of opioids and number of supplemental doses administered in both groups were documented.<\/jats:p>\n        <jats:p>\n          <jats:bold>RESULTS<\/jats:bold> Although there was no difference in gestational age or weight at birth between the DEX and no-DEX groups, the DEX group's median postconceptional date was older at the time of surgery (39.6 vs 37.4 weeks; p = 0.003). Patients in the DEX group experienced more episodes of bradycardia (12.8% vs 5.1%; p = 0.01). There was no difference between groups in episodes of hypotension or respiratory depression. The cumulative dose of opioids was significantly lower in the DEX group compared with the no-DEX group (1155 mcg\/kg vs 1841 mcg\/kg; p = 0.01). There was no difference in the number of supplemental doses of opioids given between the groups.<\/jats:p>\n        <jats:p>\n          <jats:bold>CONCLUSIONS<\/jats:bold> The addition of DEX to opioid infusions resulted in a significant decrease in the cumulative dose of opioids but was associated with more episodes of bradycardia than opioids alone.<\/jats:p>","DOI":"10.5863\/1551-6776-24.3.227","type":"journal-article","created":{"date-parts":[[2019,5,10]],"date-time":"2019-05-10T17:06:56Z","timestamp":1557508016000},"page":"227-233","source":"Crossref","is-referenced-by-count":9,"title":["Dexmedetomidine for the Management of Postoperative Pain and Sedation in Newborns"],"prefix":"10.5863","volume":"24","author":[{"given":"Maria N.","family":"Sellas","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kay C.","family":"Kyllonen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maryjoy R.","family":"Lepak","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ricardo J.","family":"Rodriguez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"3883","reference":[{"key":"i1551-6776-24-3-227-b1","series-title":"Precedex [package insert]","year":"1999","unstructured":"Precedex [package insert]. Lake Forest, IL: Hospira, Inc; 1999."},{"issue":"1","key":"i1551-6776-24-3-227-b2","series-title":"Pain Ther","first-page":"63","article-title":"Efficacy of intra-operative dexmedetomidine compared with placebo for postoperative pain management: a meta-analysis of published studies","volume":"5","year":"2016","unstructured":"Bellon\n              M\n            , Le BotA, MicheletD, \n          et al. Efficacy of intra-operative dexmedetomidine compared with placebo for postoperative pain management: a meta-analysis of published studies. Pain Ther. 2016;5(1):63\u201380."},{"issue":"3","key":"i1551-6776-24-3-227-b3","series-title":"Paediatr Anaesth","first-page":"239","article-title":"Outcomes of dexmedetomidine treatment in pediatric patients undergoing congenital heart disease surgery: a meta-analysis","volume":"26","year":"2016","unstructured":"Pan\n              W\n            , WangY, LinL, \n          et al. Outcomes of dexmedetomidine treatment in pediatric patients undergoing congenital heart disease surgery: a meta-analysis. Paediatr Anaesth. 2016;26(3):239\u2013248."},{"issue":"49","key":"i1551-6776-24-3-227-b4","series-title":"Medicine","first-page":"49","article-title":"Effects of intraoperative dexmedetomidine with intravenous anesthesia on postoperative emergence agitation\/delirium in pediatric patients undergoing tonsillectomy with or without adenoidectomy","volume":"95","year":"2016","unstructured":"Cao\n              JL\n            , PeiYP, WeiJQ, ZhangY. Effects of intraoperative dexmedetomidine with intravenous anesthesia on postoperative emergence agitation\/delirium in pediatric patients undergoing tonsillectomy with or without adenoidectomy. 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Developmental pharmacology\u2013drug disposition, action, and therapy in infants and children. N Engl J Med. 2003;349(12):1157\u20131167."},{"issue":"3","key":"i1551-6776-24-3-227-b11","series-title":"J Pediatr Pharmacol Ther","first-page":"252","article-title":"Dexmedetomidine versus standard therapy with fentanyl for sedation in mechanically ventilated premature neonates","volume":"17","year":"2012","unstructured":"O'Mara\n              K\n            , GalP, WimmerJ, \n          et al. Dexmedetomidine versus standard therapy with fentanyl for sedation in mechanically ventilated premature neonates. J Pediatr Pharmacol Ther. 2012;17(3):252\u2013262."},{"issue":"5","key":"i1551-6776-24-3-227-b12","series-title":"South Med J","first-page":"451","article-title":"Sedation during mechanical ventilation in infants and children: dexmedetomidine versus midazolam","volume":"97","year":"2004","unstructured":"Tobias\n              JD\n            , BerkenboschJW. 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J Neurosci. 2002;22(17):7650\u20137661."}],"container-title":["The Journal of Pediatric Pharmacology and Therapeutics"],"original-title":[],"link":[{"URL":"https:\/\/jppt.kglmeridian.com\/view\/journals\/jppt\/24\/3\/article-p227.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/meridian.allenpress.com\/jppt\/article-pdf\/24\/3\/227\/2467275\/1551-6776-24_3_227.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/jppt.kglmeridian.com\/downloadpdf\/journals\/jppt\/24\/3\/article-p227.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/jppt.kglmeridian.com\/downloadpdf\/journals\/jppt\/24\/3\/article-p227.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,16]],"date-time":"2025-05-16T00:42:28Z","timestamp":1747356148000},"score":1,"resource":{"primary":{"URL":"https:\/\/jppt.kglmeridian.com\/view\/journals\/jppt\/24\/3\/article-p227.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019]]},"references-count":17,"journal-issue":{"issue":"3"},"URL":"https:\/\/doi.org\/10.5863\/1551-6776-24.3.227","relation":{},"ISSN":["1551-6776"],"issn-type":[{"value":"1551-6776","type":"print"}],"subject":[],"published":{"date-parts":[[2019]]}}}