Abstract
ObjectiveTo examine the therapeutic potential of stochastic vibrotactile stimulation (SVS) as a complementary non-pharmacological intervention for withdrawal in opioid-exposed newborns.Study designA prospective, within-subjects single-center study was conducted in 26 opioid-exposed newborns (>37 weeks; 16 male) hospitalized since birth and treated pharmacologically for Neonatal Abstinence Syndrome. A specially-constructed mattress delivered low-level SVS (30-60Hz, 10–12μm RMS), alternated in 30-min intervals between continuous vibration (ON) and no vibration (OFF) over a 6–8 hr session. Movement activity, heart rate, respiratory rate, axillary temperature and blood-oxygen saturation were calculated separately for ON and OFF.ResultsThere was a 35% reduction in movement activity with SVS (p<0.001), with significantly fewer movement periods >30 sec duration for ON than OFF (p = 0.003). Incidents of tachypneic breaths and tachycardic heart beats were each significantly reduced with SVS, whereas incidents of eupneic breaths and eucardic heart beats each significantly increased with SVS (p<0.03). Infants maintained body temperature and arterial-blood oxygen level independent of stimulation condition.ConclusionsSVS reduced hyperirritability and pathophysiological instabilities commonly observed in pharmacologically-managed opioid-exposed newborns. SVS may provide an effective complementary therapeutic intervention for improving autonomic function in newborns with Neonatal Abstinence Syndrome.
Highlights
Drug withdrawal in newborn infants from drug exposure during pregnancy is a growing and costly public health problem due in large part to unprecedented maternal use and addiction to opioids [1,2,3,4]
There was a 35% reduction in movement activity with stochastic vibrotactile stimulation (SVS) (p30 sec duration for ON than OFF (p = 0.003)
Incidents of tachypneic breaths and tachycardic heart beats were each significantly reduced with SVS, whereas incidents of eupneic breaths and eucardic heart beats each significantly increased with SVS (p
Summary
Drug withdrawal in newborn infants from drug exposure during pregnancy is a growing and costly public health problem due in large part to unprecedented maternal use and addiction to opioids [1,2,3,4]. Non-pharmacological strategies such as minimizing environmental stimuli, swaddling and positioning, and improving caloric intake are considered as the first-line treatment of infants with NAS [10,11,12,13,14], and there is some recent evidence that parental rooming-in models may reduce withdrawal symptoms, facilitate weaning, decrease length of stay and reduce pharmacotherapy requirement [15, 16]. Many of these strategies may not be feasible or effectively carried out. Effects of medication and non-pharmacological interventions on autonomic, sensory, and motor activity remain largely unstudied [7, 8, 12, 14]
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