Cochrane · systematic review · CD014876
Systemic opioids versus other analgesics and sedatives for postoperative pain in neonates
Kinoshita, M, Stempel, KS, Borges do Nascimento, IJ, et al. · Cochrane Database of Systematic Reviews · 2023 · 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
21
current version
GRADE rated
3
No studies
18
Included studies
NR
No studies 18 · 85.7%Ungraded 0 · 0%Very low 3 · 14.3%Low 0 · 0%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
Tramadol compared to no treatment or placebo for postoperative pain in neonates
Population: postoperative pain in preterm and term infants
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Pain Tramadol vs no treatment or placebo | no estimate extracted | NR | No studies |
Major neurodevelopmental disability in children aged 18 to 24 months Tramadol vs no treatment or placebo | no estimate extracted | NR | No studies |
Major neurodevelopmental disability in children aged three to five years Tramadol vs no treatment or placebo | no estimate extracted | NR | No studies |
Cognitive and educational outcomes in children more than five years old Tramadol vs no treatment or placebo | no estimate extracted | NR | No studies |
All‐cause mortality during initial hospitalization Tramadol vs no treatment or placebo | RR 0.32 [0.01, 7.7] | 1 study · 71 participants | Very low Downgraded: risk of bias, imprecision |
Severe retinopathy of prematurity (defined as stage 3 or greater) Tramadol vs no treatment or placebo | no estimate extracted | NR | No studies |
Severe intraventricular hemorrhage (grade 3 or greater) on cranial ultrasound, as per Papile classification Tramadol vs no treatment or placebo | no estimate extracted | NR | No studies |
Fentanyl compared to tramadol for postoperative pain in neonates
Population: postoperative pain in preterm and term infants
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Pain Fentanyl vs tramadol | no estimate extracted | NR | No studies |
Major neurodevelopmental disability in children aged 18 to 24 months Fentanyl vs tramadol | no estimate extracted | NR | No studies |
Major neurodevelopmental disability in children aged three to five years Fentanyl vs tramadol | no estimate extracted | NR | No studies |
Cognitive and educational outcomes in children more than five years old Fentanyl vs tramadol | no estimate extracted | NR | No studies |
All‐cause mortality during initial hospitalization Fentanyl vs tramadol | RR 0.99 [0.59, 1.64] | 1 study · 171 participants | Very low Downgraded: risk of bias, imprecision |
Severe retinopathy of prematurity (defined as stage 3 or greater) Fentanyl vs tramadol | no estimate extracted | NR | No studies |
Severe intraventricular hemorrhage (grade 3 or greater) on cranial ultrasound, as per Papile classification Fentanyl vs tramadol | no estimate extracted | NR | No studies |
Morphine compared to paracetamol for postoperative pain in neonates
Population: postoperative pain in preterm and term infants
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Pain Morphine vs paracetamol | no estimate extracted | 1 study · 71 participants | Very low Downgraded: risk of bias, imprecision |
Major neurodevelopmental disability in children aged 18 to 24 months Morphine vs paracetamol | no estimate extracted | NR | No studies |
Major neurodevelopmental disability in children aged three to five years Morphine vs paracetamol | no estimate extracted | NR | No studies |
Cognitive and educational outcomes in children more than five years old Morphine vs paracetamol | no estimate extracted | NR | No studies |
All‐cause mortality during initial hospitalization Morphine vs paracetamol | no estimate extracted | NR | No studies |
Severe retinopathy of prematurity (defined as stage 3 or greater) Morphine vs paracetamol | no estimate extracted | NR | No studies |
Severe intraventricular hemorrhage (grade 3 or greater) on cranial ultrasound, as per Papile classification Morphine vs paracetamol | no estimate extracted | NR | No studies |