Resolution of opioid-induced postoperative ileus in a newborn infant after methylnaltrexone.

Abstract

Transient impairment of bowel function is a frequent and distressing problem in neonates on opioid-induced analgesia. Methylnaltrexone, a peripheral-acting μ-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.

• Authors: Lars Garten, Petra Degenhardt, Christoph Bührer
• Journal: Journal of pediatric surgery (J Pediatr Surg) Vol. 46 Issue 3 Pg. e13-5 (Mar 2011) ISSN: 1531-5037 [Electronic] United States
• PMID: 21376180 (Publication Type: Case Reports, Journal Article)
• Copyright: Copyright © 2011 Elsevier Inc. All rights reserved.

Chemical References

• Narcotic Antagonists
• Narcotics
• Quaternary Ammonium Compounds
• methylnaltrexone
• Naltrexone
• Fentanyl

Topics

• Aortic Arch Syndromes (surgery)
• Coronary Disease (complications, therapy)
• Extracorporeal Membrane Oxygenation
• Fatal Outcome
• Female
• Fentanyl (adverse effects, therapeutic use)
• Humans
• Infant, Newborn
• Intestinal Pseudo-Obstruction (chemically induced, drug therapy)
• Naltrexone (analogs & derivatives, therapeutic use)
• Narcotic Antagonists (therapeutic use)
• Narcotics (adverse effects)
• Pain, Postoperative (drug therapy)
• Postoperative Complications (chemically induced, drug therapy)
• Quaternary Ammonium Compounds (therapeutic use)
• Remission Induction