Opioids for managing pain in babies exposed to painful proce | Figure 1
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Opioids for managing pain in babies exposed to painful procedures
Key messages
- Due to a lack of strong evidence, the benefits and risks of opioids for managing pain in babies exposed to painful procedures are unclear.
- Compared to placebo, opioids may reduce pain assessed with certain scales during the procedure, but may not make a difference with other scales one to two hours after the procedure.
- The evidence is very uncertain about the effect of opioids on: pain assessed with other pain scores or at different time points, episodes of bradycardia, or hypotension. Opioids may increase episodes of breathing stops.
What did we find?
We included 13 studies involving a total of 823 babies. The largest study was in 150 babies, and the smallest in 12 babies. All studies were performed in a hospital. Four studies were conducted in India, two each in Italy and the UK, one each in Canada, Finland, Iran, and the USA, and one was an international study conducted in France and the USA.
Seven studies compared opioids to placebo; two studies compared opioids to oral sweet solution or other treatments such as touching the baby's body; and five studies compared opioids to another drug.
Compared to placebo, opioids probably result in a reduction in pain score assessed with certain scales during the procedure, but in little or no difference between groups with other scales one to two hours after the procedure. The evidence is very uncertain about the effect of opioids on pain assessed with other pain scores or at different time points. The evidence is very uncertain about the effect of opioids on episodes of bradycardia, hypotension or breathing stops requiring resuscitation. Opioids may increase episodes of breathing stops. No studies reported parent satisfaction with medical care.
The evidence is very uncertain about the effect of opioids on any outcome when compared to other treatments, such as touching the baby's body or giving other drugs.
Limitations of the evidence
We are not confident in the evidence because there are not enough studies to be certain about the results of our outcomes. Moreover, it is possible that people in the studies were aware of what treatment they were giving to the babies. Few studies provided data about everything that we were interested in.