Depression of cortical neuronal activity after a low‐dose fentanyl in preterm infants

Author:

Nilsson Sofie1ORCID,Tokariev Anton2,Vehviläinen Timo2,Fellman Vineta13ORCID,Vanhatalo Sampsa24ORCID,Norman Elisabeth1ORCID

Affiliation:

1. Pediatrics, Department of Clinical Sciences Lund Lund University, Skane University Hospital Lund Sweden

2. Department of Clinical Neurophysiology, BABA Center, New Children's Hospital Helsinki University Hospital and University of Helsinki Helsinki Finland

3. Folkhälsan Research Center and Children's Hospital University of Helsinki Helsinki Finland

4. Department of Physiology, Clinicum University of Helsinki Helsinki Finland

Abstract

AbstractAimOpioids might be harmful to the developing brain and dosing accuracy is important. We aimed at investigating fentanyl effects on cortical activity in infants using computational re‐analysis of bedside recorded EEG signals.MethodsFifteen infants born at median 26.4 gestational weeks (range 23.3–34.1), with a birth weight 740 grams (530–1420) and postnatal age 7 days (5–11) received fentanyl 0.5 or 2 μg/kg intravenously before a skin‐breaking procedure or tracheal intubation, respectively. Cortical activity was continuously recorded using amplitude‐integrated electroencephalography (aEEG).  Analyses using three computational EEG features representing cortical synchrony and signal power, were conducted five minutes pre‐ and 10 minutes post the drug administration.ResultsVisual assessment of trends displayed from the EEG metrics did not indicate systematic changes. However, the magnitude of the changes in the parietal and right hemisphere signals after the dose was significantly correlated (ρ < −0.5, p < 0.05) to the EEG amplitude and frequency power level before drug administration. This effect started after 3–4 min.ConclusionFentanyl, even in small doses, may affect cortical activity in the preterm brain. The effect is robustly related to the state of cortical activity prior to drug treatment, which must be taken into account when analysing the effects of sedative drugs.

Publisher

Wiley

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