Journal
JOURNAL OF PEDIATRIC SURGERY
Volume 46, Issue 3, Pages E13-E15Publisher
W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1016/j.jpedsurg.2010.10.015
Keywords
Bowel dysfunction; Newborn; Opiate mu-receptor antagonist; Abdominal surgery
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Transient impairment of bowel function is a frequent and distressing problem in neonates on opioid-induced analgesia. Methylnaltrexone, a peripheral-acting mu-opioid receptor antagonist, has been studied in adults for the treatment of opioid-induced constipation in advanced illness and has been suggested as a promising therapeutic concept for reducing postoperative ileus. Here, we report on a newborn infant on fentanyl analgesia after major abdominal surgery with aggravated ileus. After 8 days of quiescent bowel, the patient's intestinal dysmotility resolved within 15 minutes after intravenous administration of methylnaltrexone (0.15 mg/kg body weight). Methylnatrexone was repeated daily until cessation of fentanyl administration. There were no signs of pain or opioid withdrawal. (C) 2011 Elsevier Inc. All rights reserved.
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