ArticleJournal of perinatology : official journal of the California Perinatal Association2026
Analgesia and sedation trends in a level IV NICU, 2014-2024: Opioid and dexmedetomidine use.
Article in Journal of perinatology : official journal of the California Perinatal Association, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveExamine 11-year trends in opioid and sedative exposure and dosing practices in a level IV neonatal intensive care unit (NICU).
methodsThis retrospective cohort study included NICU admissions from 2014 to 2024 that received at least one opioid or sedative. Temporal changes in patient characteristics, exposure patterns, continuous infusion regimen composition, and morphine and dexmedetomidine infusion rates were evaluated across three epochs (2014-2017, 2018-2021, 2022-2024).
resultsOf 2055 admissions, 1060 (51.6%) encounters were analyzed. Infants admitted in later years were more premature with greater morbidity. Dexmedetomidine continuous infusion use increased fivefold (7.9% to 44.1%; p < 0.001), while morphine infusion use also increased (36.7% to 50.4%; p = 0.0021). Morphine plus dexmedetomidine became the most common continuous infusion regimen by 2022-2024 (28.7%), with higher infusion rates in combination therapy than in monotherapy.
conclusionNICU sedation strategies shifted from morphine monotherapy toward combination therapy with dexmedetomidine. Standardized, outcome-oriented guidelines and multicenter studies are needed.
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