The use of opioids in neonates. A retrospective study of 933 cases

This is a retrospective study on the use of postoperative opioids in neonates admitted to the surgical intensive care unit at Great Ormond Street over a 5-year period (1980-84). A total of 131 (14%) babies received opioids out of 933 neonates admitted to the unit. The use of opioids increased from 9.7% to 27.2% of admitted cases during the survey period. Postoperative ventilation of the lungs was necessary in 240 (25.7%) cases and 88 (36.6%) of these were given opioids. Four babies initially failed to wean from controlled ventilation as a result of opioid induced respiratory depression. A total of 51 (7.35%) spontaneously breathing neonates received opioids and seven (13.7%) of these developed apnoea or respiratory failure thought to be induced by opioids. The administration of opioids by nurses occurred most frequently in the late evening and early hours of the morning, when medical cover is at its lowest level.