Please use this identifier to cite or link to this item: https://observatorio.fm.usp.br/handle/OPI/30020
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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.authorBICHAFF, Pedro
dc.contributor.authorSETANI, Karina T.
dc.contributor.authorMOTTA, Emiliana H. G.
dc.contributor.authorDELGADO, Artur F.
dc.contributor.authorCARVALHO, Werther B.
dc.contributor.authorLUGLIO, Michele
dc.date.accessioned2019-01-17T13:35:20Z-
dc.date.available2019-01-17T13:35:20Z-
dc.date.issued2018
dc.identifier.citationREVISTA DA ASSOCIACAO MEDICA BRASILEIRA, v.64, n.10, p.909-915, 2018
dc.identifier.issn0104-4230
dc.identifier.urihttps://observatorio.fm.usp.br/handle/OPI/30020-
dc.description.abstractOBJECTIVE: Opioid abstinence syndrome is common in the pediatric intensive care environment because sedation is often needed during the children's treatment. There is no specific guideline regarding the management of these patients; and lately, methadone is an important drug for the prevention of abstinence symptoms during the weaning of opioids. This study gathers the available research to establish the initial dose of methadone, the rate of taper and tools to recognize this syndrome and act promptly. METHODS: A systematic review was made from data of four different databases. Forty-nine articles of observational and experimental studies were selected based on the inclusion criteria (critical pediatric patients in acute use of opioids) and exclusion criteria (previous chronic use of opioids, other medications). The data regarding specific themes were separated in sections: initial dose of methadone, use of protocols in clinical practice, abstinence scales and adjuvant drugs. RESULTS: The articles showed a great heterogeneity of ways to calculate the initial dose of methadone. The pediatric intensive care units of the study had different weaning protocols, with a lower incidence of abstinence when a pre-defined sequence of tapering was used. The Withdrawal Assessment Tool - 1 was the most used scale for tapering the opioids, with good sensitivity and specificity for signs and symptoms. CONCLUSION: There is still little evidence of other medications that can help prevent the abstinence syndrome of opioids. This study tries to promote a better practice during opioid weaning.eng
dc.language.isoeng
dc.publisherASSOC MEDICA BRASILEIRAeng
dc.relation.ispartofRevista da Associacao Medica Brasileira
dc.rightsopenAccesseng
dc.subjectRevieweng
dc.subjectCritical Careeng
dc.subjectAnalgesics, Opioideng
dc.subjectChildeng
dc.subjectSubstance Withdrawal Syndromeeng
dc.subject.otherwithdrawal symptomseng
dc.subject.otherabstinence syndromeeng
dc.subject.otherill childreneng
dc.subject.othermethadoneeng
dc.subject.othersedationeng
dc.subject.othermanagementeng
dc.subject.othertoleranceeng
dc.subject.otheranalgesiaeng
dc.subject.otherfentanyleng
dc.subject.otherdetoxificationeng
dc.titleOpioid tapering and weaning protocols in pediatric critical care units: a systematic revieweng
dc.typearticleeng
dc.rights.holderCopyright ASSOC MEDICA BRASILEIRAeng
dc.identifier.doi10.1590/1806-9282.64.10.909
dc.identifier.pmid30517238
dc.subject.wosMedicine, General & Internaleng
dc.type.categoryrevieweng
dc.type.versionpublishedVersioneng
hcfmusp.description.beginpage909
hcfmusp.description.endpage915
hcfmusp.description.issue10
hcfmusp.description.volume64
hcfmusp.origemWOS
hcfmusp.origem.idWOS:000451927800009
hcfmusp.origem.id2-s2.0-85057714729
hcfmusp.origem.idSCIELO:S0104-42302018001000909
hcfmusp.publisher.citySAO PAULOeng
hcfmusp.publisher.countryBRAZILeng
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dc.description.indexMEDLINEeng
hcfmusp.citation.scopus5-
hcfmusp.scopus.lastupdate2024-02-23-
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Artigos e Materiais de Revistas Científicas - FM/MPE
Departamento de Pediatria - FM/MPE

Artigos e Materiais de Revistas Científicas - HC/ICr
Instituto da Criança - HC/ICr

Artigos e Materiais de Revistas Científicas - HC/InCor
Instituto do Coração - HC/InCor

Artigos e Materiais de Revistas Científicas - LIM/36
LIM/36 - Laboratório de Pediatria Clínica


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