Methadone, or in Germany levomethadone, may be used for the treatment of iatrogenic opioid withdrawal syndrome in pediatric intensive care units. The limited literature on opioid rotation in children does not provide data for the switch from methadone to another opioid. We report switching a very ill preterm baby in an unstable condition from IV levomethadone to IV fentanyl identifying a possible conversion ratio of 6.0-4.5:1 emphasizing critical steps as equipotency appropriate for neonates and dose reduction for incomplete cross-tolerance. If clinical deterioration occurs in infants on opioid tapering with levomethadone, we hope that our observations may be helpful.
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Switching a baby from IV levomethadone to IV fentanyl.
J Opioid Manag
April 2021
Neonatology and Neonatal Intensive Care, Dr. von Hauner Children's Hospital, University of Munich Medical Center, Ludwig-Maximilians-University, Munich, Germany.
Methadone, or in Germany levomethadone, may be used for the treatment of iatrogenic opioid withdrawal syndrome in pediatric intensive care units. The limited literature on opioid rotation in children does not provide data for the switch from methadone to another opioid. We report switching a very ill preterm baby in an unstable condition from IV levomethadone to IV fentanyl identifying a possible conversion ratio of 6.
View Article and Find Full Text PDFAssessment of the effects of adjunctive gabapentin on postoperative pain after intervertebral disc surgery in dogs.
Vet Anaesth Analg
November 2012
Small Animal Clinic, University of Veterinary Medicine Hannover, Foundation, Hannover, Germany.
Objective: To assess the effect of adjunctive gabapentin (GBP) on pain after thoracolumbar intervertebral disc surgery in dogs.
Study Design: Prospective, randomized, controlled, clinical, 'blinded' trial.
Animals: Sixty-three client owned dogs undergoing hemilaminectomy
Methods: Dogs were assigned to two treatment groups.
[Switching opioids to transdermal fentanyl in a clinical setting].
Schmerz
August 1999
Klinik und Poliklinik für Anästhesiologie und Operative Intensivmedizin, Universität Köln, Cologne
Introduction: The use of transdermal fentanyl is gaining in importance in the management of cancer pain. We describe the reasons for switching opioid medication to transdermal fentanyl in a pain management unit.
Methods: Case records of patients treated with transdermal fentanyl in our pain clinic were evaluated retrospectively.
[The use of narcotics in veterinary practice and hospitals in the Federal Republic of Germany including Berlin-West].
Offentl Gesundheitswes
May 1991
Institut für Pharmakologie und Toxikologie, Fachbereich Veterinärmedizin Freien Universität Berlin.
An inquiry on the use of narcotics was carried through among practising veterinary surgeons and in animal hospitals. Of 5907 questionnaires sent out 2725 (46.1%) were returned; 86.
View Article and Find Full Text PDFThe short introduction gives a review on the complex of exogen and endogen opioids and their receptors as well as on their pharmacodynamics, pharmacokinetics and toxicity of naloxone. The clinical efficacy of naloxone as an opioid antagonist is described. Applications of naloxone for the dog are specified: antagonisation of etorphine, morphine, levomethadone and fentanyl, antagonisation of exogen and endogen opioids in puppies and treatment of lactomania in the bitch.
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