Gabapentin for Delirium in Infants in the Neonatal Intensive Care Unit.

Q2 Medicine
Eugenie Chang, Avery Parman, Peter N Johnson, Katy Stephens, Stephen Neely, Nalini Dasari, Netsanet Kassa, Jamie L Miller
{"title":"Gabapentin for Delirium in Infants in the Neonatal Intensive Care Unit.","authors":"Eugenie Chang, Avery Parman, Peter N Johnson, Katy Stephens, Stephen Neely, Nalini Dasari, Netsanet Kassa, Jamie L Miller","doi":"10.5863/1551-6776-29.5.487","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>A protocol was developed for neonatal intensive care unit (NICU) delirium: Step 1, gabapentin for pain or melatonin for sleep; Step 2, add on other Step 1 agent; Step 3, antipsychotics. The purpose of this study was to describe the utility and dosing of gabapentin for NICU delirium.</p><p><strong>Methods: </strong>Retrospective evaluation of NICU patients from January 1, 2021-December 31, 2022 who received >1 dose of gabapentin based on the delirium protocol. Data collection included demographics, gabapentin regimen, and concomitant sedatives and analgesics. The primary objective was to identify the number of patients receiving gabapentin for Step 1 or Step 2. Secondary objectives included identifying the number of patients requiring antipsychotics (Step 3), the gabapentin regimen, comparison of Échelle de Douleur et d'Inconfort du Nouveau-né (EDIN), Cornell Assessment of Pediatric Delirium (CAPD), and Withdrawal Assessment Tool-1 (WAT-1) scores 72 hours pre- and post-gabapentin initiation, and comparison of opioids, clonidine, and melatonin 24 hours pre- and 72 hours post-gabapentin initiation. Wilcoxon signed rank tests were employed with significance defined at p < 0.05.</p><p><strong>Results: </strong>Twenty-nine patients were studied. The majority (n = 22; 75.9%) received gabapentin for Step 1; no patients required Step 3. The median initial dose was 14.4 mg/kg/day divided every 8 hours. Twelve (41.4%) required increase to a median of 16.9 mg/kg/day. A significant decrease in EDIN and WAT-1 scores was noted, but there was no change in CAPD scores or opioid, clonidine, or melatonin doses pre- versus post-gabapentin.</p><p><strong>Conclusion: </strong>The majority received gabapentin at a median dose of 14 mg/kg/day as Step 1 for delirium. Gabapentin was associated with a significant decrease in pain and withdrawal scores.</p>","PeriodicalId":37484,"journal":{"name":"Journal of Pediatric Pharmacology and Therapeutics","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11472400/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Pediatric Pharmacology and Therapeutics","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.5863/1551-6776-29.5.487","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/10/14 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0

Abstract

Objective: A protocol was developed for neonatal intensive care unit (NICU) delirium: Step 1, gabapentin for pain or melatonin for sleep; Step 2, add on other Step 1 agent; Step 3, antipsychotics. The purpose of this study was to describe the utility and dosing of gabapentin for NICU delirium.

Methods: Retrospective evaluation of NICU patients from January 1, 2021-December 31, 2022 who received >1 dose of gabapentin based on the delirium protocol. Data collection included demographics, gabapentin regimen, and concomitant sedatives and analgesics. The primary objective was to identify the number of patients receiving gabapentin for Step 1 or Step 2. Secondary objectives included identifying the number of patients requiring antipsychotics (Step 3), the gabapentin regimen, comparison of Échelle de Douleur et d'Inconfort du Nouveau-né (EDIN), Cornell Assessment of Pediatric Delirium (CAPD), and Withdrawal Assessment Tool-1 (WAT-1) scores 72 hours pre- and post-gabapentin initiation, and comparison of opioids, clonidine, and melatonin 24 hours pre- and 72 hours post-gabapentin initiation. Wilcoxon signed rank tests were employed with significance defined at p < 0.05.

Results: Twenty-nine patients were studied. The majority (n = 22; 75.9%) received gabapentin for Step 1; no patients required Step 3. The median initial dose was 14.4 mg/kg/day divided every 8 hours. Twelve (41.4%) required increase to a median of 16.9 mg/kg/day. A significant decrease in EDIN and WAT-1 scores was noted, but there was no change in CAPD scores or opioid, clonidine, or melatonin doses pre- versus post-gabapentin.

Conclusion: The majority received gabapentin at a median dose of 14 mg/kg/day as Step 1 for delirium. Gabapentin was associated with a significant decrease in pain and withdrawal scores.

加巴喷丁治疗新生儿重症监护病房婴儿的谵妄。
目的:针对新生儿重症监护室(NICU)谵妄制定了一套方案:第 1 步:加巴喷丁止痛或褪黑素助眠;第 2 步:添加其他第 1 步药物;第 3 步:抗精神病药物。本研究旨在描述加巴喷丁治疗新生儿重症监护室谵妄的效用和剂量:方法:回顾性评估 2021 年 1 月 1 日至 2022 年 12 月 31 日期间根据谵妄治疗方案接受过一次以上剂量加巴喷丁治疗的新生儿重症监护病房患者。收集的数据包括人口统计学、加巴喷丁方案以及同时使用的镇静剂和镇痛剂。首要目标是确定在步骤 1 或步骤 2 中接受加巴喷丁治疗的患者人数。次要目标包括确定需要使用抗精神病药物(第 3 步)的患者人数、加巴喷丁治疗方案、加巴喷丁起始前 72 小时和起始后 72 小时的Échelle de Douleur et d'Inconfort du Nouveau-né (EDIN)、康奈尔儿童谵妄评估 (CAPD) 和戒断评估工具-1 (WAT-1) 评分比较,以及阿片类药物、氯尼丁和褪黑素在加巴喷丁起始前 24 小时和起始后 72 小时的比较。采用 Wilcoxon 符号秩检验,显著性定义为 p <0.05:研究了 29 名患者。大多数患者(n = 22;75.9%)在第 1 步接受了加巴喷丁治疗;没有患者需要第 3 步治疗。初始剂量中位数为 14.4 毫克/千克/天,每 8 小时一次。有 12 名患者(41.4%)需要增加剂量,中位数为 16.9 毫克/千克/天。EDIN和WAT-1评分明显下降,但CAPD评分或阿片类药物、氯尼丁或褪黑素剂量在加巴喷丁前后没有变化:大多数患者接受了加巴喷丁治疗,中位剂量为 14 毫克/千克/天,作为治疗谵妄的第一步。加巴喷丁可显著降低疼痛和戒断评分。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
Journal of Pediatric Pharmacology and Therapeutics
Journal of Pediatric Pharmacology and Therapeutics Medicine-Pediatrics, Perinatology and Child Health
CiteScore
2.40
自引率
0.00%
发文量
90
期刊介绍: The Journal of Pediatric Pharmacology and Therapeutics is the official journal of the Pediatric Pharmacy Advocacy Group. JPPT is a peer-reviewed multi disciplinary journal that is devoted to promoting the safe and effective use of medications in infants and children. To this end, the journal publishes practical information for all practitioners who provide care to pediatric patients. Each issue includes review articles, original clinical investigations, case reports, editorials, and other information relevant to pediatric medication therapy. The Journal focuses all work on issues related to the practice of pediatric pharmacology and therapeutics. The scope of content includes pharmacotherapy, extemporaneous compounding, dosing, methods of medication administration, medication error prevention, and legislative issues. The Journal will contain original research, review articles, short subjects, case reports, clinical investigations, editorials, and news from such organizations as the Pediatric Pharmacy Advocacy Group, the FDA, the American Academy of Pediatrics, the American Society of Health-System Pharmacists, and so on.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信