Effect of opioid-induced analgesia on beta-endorphin, cortisol and glucose responses in neonates with cardiorespiratory problems.

The effects of analgesia on plasma beta-endorphin (beta-E), serum cortisol and blood glucose responses were investigated in 20 distressed, mechanically ventilated neonates during the first 3 days of life. Morphine 0.1 mg/kg, meperidine 1 mg/kg or alfentanil 10 micrograms/kg were used for analgesia as clinically indicated. Plasma beta-E, serum cortisol and blood glucose were recorded before analgesia and 1 and/or 2, 12 and 24 h afterwards in the distress group and once in 20 healthy neonates (control group). beta-E, cortisol, and blood glucose before analgesia were significantly higher in the distress group than in the control group. Cortisol values had decreased significantly 2 h after analgesia and blood glucose within 12 h. Plasma beta-E values had decreased to the same level as in the controls 24 h after the start of analgesia. The results indicate that the stress response in the distressed neonates with cardiorespiratory problems, as assessed by beta-E, cortisol, and blood glucose, is attenuated by opioid medication, and it is concluded that these patients should be given adequate analgesia.