The clinical pharmacology of short acting analgo-sedatives in neonates

Karel Allegaert*

*Corresponding author for this work

Research output: Contribution to journalReview articlePopular

16 Citations (Scopus)

Abstract

Effective pain management remains an important indicator of the quality of care provided to neonates, not only from an ethical, but also from a clinical outcome perspective. Significant progresses in non-pharmacological therapies have been made. However - in the meanwhile - neonatal practice also evolved. These shifts in clinical care also induced in a shift in pharmacodynamic end points, and consequently, new pharmacological observations are needed with emphasis on short acting procedural analgo-sedatives. Analgo-sedation in neonates remains a balanced decision based on systematic assessment (pharmacodynamics, PD), followed by titrated administration of the most appropriate analgesic(s) (PK) with subsequent re-assessment (PD) to adapt and further titrate exposure and effects. In this review, we will focus on aspects of the clinical pharmacology (pharmacokinetics (PK) and -dynamics) of newly emerging, short acting analgo-sedatives (midazolam, propofol, remifentanil, inhalational agents, ketamine) in neonates. Based on the currently available information on predictability of disposition and the limited pharmacodynamic side effects (hemodynamics, neuro-apoptosis), it seems that remifentanil is the most promising compound for further evaluation.

Original languageEnglish
Pages (from-to)222-226
Number of pages5
JournalCurrent Clinical Pharmacology
Volume6
Issue number4
DOIs
Publication statusPublished - Nov 2011
Externally publishedYes

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