methylnaltrexone and Intestinal-Pseudo-Obstruction

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.

Topics: Aortic Arch Syndromes; Coronary Disease; Extracorporeal Membrane Oxygenation; Fatal Outcome; Female; Fentanyl; Humans; Infant, Newborn; Intestinal Pseudo-Obstruction; Naltrexone; Narcotic Antagonists; Narcotics; Pain, Postoperative; Postoperative Complications; Quaternary Ammonium Compounds; Remission Induction

Topics: Analgesics, Opioid; Anesthetics; Gastrointestinal Agents; Humans; Intestinal Pseudo-Obstruction; Intubation, Gastrointestinal; Naltrexone; Piperidines; Postoperative Complications; Preoperative Care; Quaternary Ammonium Compounds