Cochrane · systematic review · CD002053
Sedatives for opioid withdrawal in newborn infants
Zankl, A, Martin, J, Davey, JG, et al. · Cochrane Database of Systematic Reviews · 2021 · Cochrane Library
NeonatalAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
42
current version
GRADE rated
25
No studies
17
Included studies
NR
No studies 17 · 40.5%Ungraded 0 · 0%Very low 17 · 40.5%Low 8 · 19%Moderate 0 · 0%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Phenobarbital versus supportive care for opioid withdrawal in newborn infants
Population: newborn infants with opioid withdrawal
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Treatment failure To discharge Phenobarbital vs supportive care | RR 2.73 [0.94, 7.94] | 1 study · 62 participants | Very low Downgraded: risk of bias, imprecision |
Seizures To discharge Phenobarbital vs supportive care | no estimate extracted | 1 study · 62 participants | Very low Downgraded: risk of bias, imprecision |
Neonatal and infant mortality Phenobarbital vs supportive care | no estimate extracted | NR | No studies |
Neurodevelopmental disability Phenobarbital vs supportive care | no estimate extracted | NR | No studies |
Days' hospitalisation Phenobarbital vs supportive care | no estimate extracted | 1 study · 62 participants | Very low Downgraded: risk of bias, imprecision |
Days' pharmacological treatment Phenobarbital vs supportive care | no estimate extracted | 1 study · 62 participants | Very low Downgraded: risk of bias, imprecision |
Adverse events To discharge Phenobarbital vs supportive care | no estimate extracted | NR | No studies |
Phenobarbital versus diazepam for opioid withdrawal in newborn infants
Population: newborn infants with opioid withdrawal
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Treatment failure To discharge Phenobarbital vs diazepam | RR 0.39 [0.24, 0.62] | 2 studies · 139 participants | Low Downgraded: risk of bias, inconsistency |
Seizures To discharge Phenobarbital vs diazepam | no estimate extracted | NR | No studies |
Neonatal and infant mortality Phenobarbital vs diazepam | no estimate extracted | NR | No studies |
Neurodevelopmental disability Phenobarbital vs diazepam | no estimate extracted | NR | No studies |
Days' hospitalisation Phenobarbital vs diazepam | no estimate extracted | 1 study · 32 participants | Low Downgraded: risk of bias, imprecision |
Days' pharmacological treatment Phenobarbital vs diazepam | no estimate extracted | 1 study · 31 participants | Low Downgraded: risk of bias, imprecision |
Adverse events To discharge Phenobarbital vs diazepam | no estimate extracted | NR | No studies |
Phenobarbital versus chlorpromazine for opioid withdrawal in newborn infants
Population: newborn infants with opioid withdrawal
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Treatment failure To discharge Phenobarbital vs chlorpromazine | RR 0.55 [0.33, 0.92] | 2 studies · 138 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Seizures To discharge Phenobarbital vs chlorpromazine | no estimate extracted | 2 studies · 140 participants | Very low Downgraded: risk of bias, imprecision |
Neonatal and infant mortality Phenobarbital vs chlorpromazine | no estimate extracted | NR | No studies |
Neurodevelopmental disability Phenobarbital vs chlorpromazine | no estimate extracted | NR | No studies |
Days' hospitalisation Phenobarbital vs chlorpromazine | no estimate extracted | 1 study · 87 participants | Low Downgraded: risk of bias, imprecision |
Days' pharmacological treatment Phenobarbital vs chlorpromazine | no estimate extracted | NR | No studies |
Adverse events To discharge Phenobarbital vs chlorpromazine | no estimate extracted | 1 study · 100 participants | Low Downgraded: imprecision |
Phenobarbital and opioid versus opioid alone for opioid withdrawal in newborn infants
Population: newborn infants with opioid withdrawal
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Treatment failure To discharge Phenobarbital and opioid vs opioid alone | no estimate extracted | 1 study · 20 participants | Very low Downgraded: risk of bias, imprecision |
Seizures To discharge Phenobarbital and opioid vs opioid alone | no estimate extracted | 1 study · 20 participants | Very low Downgraded: risk of bias, imprecision |
Neonatal and infant mortality Phenobarbital and opioid vs opioid alone | no estimate extracted | NR | No studies |
Neurodevelopmental disability Phenobarbital and opioid vs opioid alone | no estimate extracted | NR | No studies |
Days' hospitalisation Phenobarbital and opioid vs opioid alone | no estimate extracted | 1 study · 20 participants | Low Downgraded: risk of bias, imprecision |
Days' pharmacological treatment Phenobarbital and opioid vs opioid alone | no estimate extracted | NR | No studies |
Adverse events To discharge Phenobarbital and opioid vs opioid alone | no estimate extracted | NR | No studies |
Clonidine and opioid versus opioid alone for opioid withdrawal in newborn infants
Population: newborn infants with opioid withdrawal
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Treatment failure To discharge Clonidine and opioid vs opioid alone | RR 0.09 [0.01, 1.59] | 1 study · 80 participants | Very low Downgraded: imprecision, inconsistency |
Seizures To discharge Clonidine and opioid vs opioid alone | RR 0.14 [0.01, 2.68] | 1 study · 80 participants | Very low Downgraded: imprecision, inconsistency |
Mortality post discharge Clonidine and opioid vs opioid alone | RR 7 [0.37, 131.28] | 1 study · 80 participants | Very low Downgraded: imprecision, inconsistency |
Neurodevelopmental disability Clonidine and opioid vs opioid alone | no estimate extracted | NR | No studies |
Days' hospitalisation Clonidine and opioid vs opioid alone | no estimate extracted | NR | No studies |
Days' pharmacological treatment Clonidine and opioid vs opioid alone | no estimate extracted | 1 study · 80 participants | Very low Downgraded: imprecision, inconsistency |
Adverse events (treatment related) To discharge Clonidine and opioid vs opioid alone | RR 3 [0.13, 71.51] | 1 study · 80 participants | Very low Downgraded: imprecision, inconsistency |
Clonidine and opioid versus phenobarbital and opioid for opioid withdrawal in newborn infants
Population: newborn infants with opioid withdrawal
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Treatment failure To discharge Clonidine and opioid vs phenobarbital and opioid | RR 2.27 [0.98, 5.25] | 2 studies · 93 participants | Very low Downgraded: risk of bias, imprecision |
Seizures To discharge Clonidine and opioid vs phenobarbital and opioid | RR 3 [0.13, 71.15] | 1 study · 68 participants | Very low Downgraded: risk of bias, imprecision |
Mortality to discharge Clonidine and opioid vs phenobarbital and opioid | no estimate extracted | 1 study · 68 participants | Very low Downgraded: risk of bias, imprecision |
Neurodevelopmental disability Clonidine and opioid vs phenobarbital and opioid | no estimate extracted | NR | No studies |
Days' hospitalisation Clonidine and opioid vs phenobarbital and opioid | no estimate extracted | 2 studies · 91 participants | Low Downgraded: risk of bias |
Days' pharmacological treatment Clonidine and opioid vs phenobarbital and opioid | no estimate extracted | 2 studies · 91 participants | Low Downgraded: risk of bias, imprecision |
Adverse events (treatment related) To discharge Clonidine and opioid vs phenobarbital and opioid | RR 1.55 [0.44, 5.4] | 2 studies · 93 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |