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Severe withdrawal syndrome in three newborns subjected to continuous opioid infusion and seizure activity dependent on brain hypoxia – ischemia. A possible link
Author(s) -
BACHIOCCO VALERIA,
LORENZINI LAURA,
BARONCINI SIMONETTA
Publication year - 2006
Publication title -
pediatric anesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.704
H-Index - 82
eISSN - 1460-9592
pISSN - 1155-5645
DOI - 10.1111/j.1460-9592.2006.01915.x
Subject(s) - medicine , hypoxia (environmental) , neurochemical , anesthesia , ischemia , opioid , sepsis , receptor , chemistry , organic chemistry , oxygen
Summary Background : The aim of this investigation was to verify whether brain hypoxia represented a risk factor for the occurrence and severity of opioid abstinence syndrome. Methods : Three newborns who manifested seizure activity as a result of hypoxia, focal brain ischemia, and hypoxia and sepsis, respectively, were compared with 17 neonates who suffered from hypoxia without developing seizure activity. Results : The first three neonates suffered a severe withdrawal syndrome (a rating on the neonatal abstinence score >17), the others did not. Conclusions : It is hypothesized that brain hypoxia facilitated the occurrence and severity of the withdrawal syndrome because some key neurochemical processes (such as N ‐methyl‐ d ‐aspartate activation, protein kinase C activation and nitric oxide production) are common to both phenomena.