Essential Analgosedation in Very Low Birth Weight Neonates (VLBW) during Assisted Pulmo-nary Ventilation - Comparison of High Frequency Oscillatory Ventilation (HFOV) and Conventio-nal Ventilation (CV)

Overview

The authors compared within the framework of a randomized comparative study necessary analgosedationduring HFOV and CV during treatment of non-complicated RDS in VLBWneonates. For basic analgosedationthe authors used opioids (sufentanil, fentanyl) which were, if necessary, combined with flunitrazepam. Myorela-xants (alcuronium) were added only in exceptional cases. The level of analgosedation depended on the patient´sclinical condition. A total of 30 patients in two groups were evaluated (HFOV n = 16, CV n = 14). The total periodof analgosedation was compared, the number of patients receiving different preparations and cumulative dailydoses of opioids and flunitrazepam.The mean period of analgosedation and its median was lower in group HFOV but the difference did not reachstatistical significance (p = 0.068). The number of patients sedated with opioids and flunitrazepam was higher ingroup CV and on the 4th - 5th day of life the difference was statistically significant (opioids p < 0.025, flunitrazepamp < 0.05). In both groups after the 4th and 5th day, due to onset of tolerance the cumulative daily doses of opioidsincreased. The differences of cumulative daily doses of different preparations between groups were not statisticallysignificant. The differences in the total ventilation period between groups were not statistically significant.

Key words:
premature neonate, analgosedation, opioids, ventilation, HFOV, RDS