Abstract
Objective The aim of this study is to evaluate the use and safety of a sedation protocol with
sevoflurane for short painful procedures in newborns.
Study Design This was a prospective and observational study conducted in a tertiary neonatal intensive
care unit. Sevoflurane was recommended in patients undergoing an invasive procedure
of short length, especially in those with spontaneous breathing or without venous
access. Its safety and efficacy was assessed by continuous monitoring of respiratory
and hemodynamic variables and clinical data recording.
Results Sevoflurane was used for 39 procedures, the main indications were: intravitreal bevacizumab
injection (12), central venous catheterization (11), and biopsy (6). The median administration
length was 14 minutes (range: 5–65 minutes). The median minimum dose was 1.5% (range:
1–3%). The median maximum dose was 2.5% (range: 1–6%). An effective control of nociceptive
manifestations was achieved in 35 cases (90%). No major adverse effects were noticed.
Main adverse effects were hypotension (8), desaturation (4), and apnea (3). All of
them were solved by decreasing (14) or discontinuing (1) the administration of sevoflurane.
Conclusion Sevoflurane is relatively easy to use and provides an optimal control of pain-related
symptoms. Its prescription should be individualized and more long-term follow-up data
are needed.
Keywords
sevoflurane - newborn - sedation - analgesia - pain - neonatal intensive care
