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Morphine exposure and prematurity affect flash visual evoked potentials in preterm infants.
Coviello, Caterina; Lori, Silvia; Bertini, Giovanna; Montano, Simona; Gabbanini, Simonetta; Bastianelli, Maria; Cossu, Cesarina; Cavaliere, Sara; Lunardi, Clara; Dani, Carlo.
Afiliación
  • Coviello C; Division of Neonatology, Careggi University Hospital of Florence, Florence, Italy.
  • Lori S; Neurophysiology Unit, Neuro-Musculo-Skeletal Department, Careggi University Hospital, Florence, Italy.
  • Bertini G; Division of Neonatology, Careggi University Hospital of Florence, Florence, Italy.
  • Montano S; Division of Neonatology, Careggi University Hospital of Florence, Florence, Italy.
  • Gabbanini S; Neurophysiology Unit, Neuro-Musculo-Skeletal Department, Careggi University Hospital, Florence, Italy.
  • Bastianelli M; Neurophysiology Unit, Neuro-Musculo-Skeletal Department, Careggi University Hospital, Florence, Italy.
  • Cossu C; Neurophysiology Unit, Neuro-Musculo-Skeletal Department, Careggi University Hospital, Florence, Italy.
  • Cavaliere S; Neurophysiology Unit, Neuro-Musculo-Skeletal Department, Careggi University Hospital, Florence, Italy.
  • Lunardi C; Division of Neonatology, Careggi University Hospital of Florence, Florence, Italy.
  • Dani C; Division of Neonatology, Careggi University Hospital of Florence, Florence, Italy.
Clin Neurophysiol Pract ; 9: 85-93, 2024.
Article en En | MEDLINE | ID: mdl-38371463
ABSTRACT

Objective:

The present study aimed to explore first the impact of perinatal risk factors on flash-VEP waves and morphology in a group of preterm infants studied at term equivalent age (TEA). Second, to correlate VEP morphology with neurological outcome at 2 years corrected age (CA).

Methods:

Infants with a gestational age (GA) at birth <32 weeks, without major brain injury, were enrolled. Multivariate regression analyses were performed, and the models were run separately for each dependent variable N2, P2, N3 latencies and P2 amplitude. Logistic regression was applied to study N4 component (present/absent) and VEP morphology (regular/irregular). The predictors were GA, bronchopulmonary dysplasia (BPD), postmenstrual age at VEP registration, cumulative morphine and fentanyl dose, and painful procedures. Lastly, linear regression models were performed to assess the relation between the Bayley-III cognitive and motor scores at 2 years CA and VEP morphology, in relation to GA, BPD, painful procedures and cumulative morphine dose.

Results:

Eighty infants were enrolled. Morphine was the predictor of N2 (R2 = 0.09, p = 0.006), P2 (R2 = 0.11, p = 0.002), and N3 (R2 = 0.13, p = 0.003) latencies. Younger GA was associated with lower amplitude (R2 = 0.05, p = 0.029). None of the independent variables predicted the presence of N4 component, nor VEP morphology in the logistic analysis. VEP morphology was not associated with cognitive and motor scores at 2 years.

Conclusions:

Morphine treatment and prematurity were risk factors for altered VEPs parameters at TEA. In our cohort VEP morphology did not predict neurological outcome.

Significance:

Morphine administration should be evaluated according to potential risks and benefits, and dosage individually accustomed, according to pain and comfort scores, considering the possible risk for neurodevelopmental impairment.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Clin Neurophysiol Pract Año: 2024 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Países Bajos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Clin Neurophysiol Pract Año: 2024 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Países Bajos