efficacy and safety of single low dose intravenous fentanyl in pain reduction of lumbar puncture in near term neonates by a randomized clinical trial

how to cite this article: fallah r, habibian s, noori-shadkam m. efficacy and safety of single low dose intravenous fentanyl in pain reduction of lumbar puncture in near term neonates by a randomized clinical trial. iran j child neurol. spring 2016; 10(2):60-66. abstract objective reduction of pain of invasive procedures in neonates can prevent pain side effects. the purpose of present study was to evaluate the efficacy and safety of a single low dose of intravenous fentanyl in reducing of lumbar puncture (lp) pain in neonates. materials & methods in this randomized clinical trial, registered with code number of 2014022616761n150, admitted neonates to shahid sadoughi hospital, yazd, iran from august-april 2012 (45 cases) were randomly assigned into two groups to receive 2 μg/kg of intravenous fentanyl or 0.2 milliliter of normal saline, two min before lp. primary outcome was success rate in reducing of pain during needle insertion to skin (pain score of less than three). secondary outcomes were clinical side effects and serious adverse events. results forty-five neonates including 23 girls and 22 boys were evaluated. pain reduction was obtained in 39.1% (9 of 23 neonates) of fentanyl group and in 4.5% (one of 22 neonates) of control group. means of pulse rate (136.41± 9.16 vs. 148.9± 8.99) and pain score during needle insertion (3.41±1.31 vs. 5.8±1.12) were lower in fentanyl group. no severe adverse effects were seen in both groups. side effects such as vomiting [9% (n=2) in control and 4.3% (n=1) in fentanyle group] and mild transient decrease in oxygen saturation in 8.7% (n=2) of fentanyle group were seen. safety in two groups was not statistically different. conclusion intravenous fentanyl might be considered as a safe and effective analgesic drug in lp in neonates. references lehman rl, schor nf. special diagnostic procedures. in: kliegman rm, stanton bf, schor nf, st. geme jw, behrman re. nelson textbook of pediatrics. philadelphia, saunders 2011; 19th edition, pp: 2013-2017. sacchetti a, baren j, carraccio c. total procedural requirements as indication for emergency department sedation. pediatr emerg care 2010;26(3):209-11. leroy pl, gorzeman mp, sury mr. procedural sedation and analgesia in children by non-anesthesiologists in an emergency department. minerva pediatr 2009;61(2):193-215. gorchynski j, mclaughlin t. the routine utilization of procedural pain management for pediatric lumbar punctures: are we there yet? 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