Everyone knows that opioids are dangerous if not prescribed cautiously and taken exactly as directed. Even when the best precautions are followed, addiction can result. Sometimes though, there is no choice.
While opioid medications can be life-saving, they can also damage the brain, especially in very young children. Researchers from Boston Children's Hospital recently presented a small study of full-term newborns who had undergone necessary surgery that included the use of morphine for post-surgical pain relief and sedation. Morphine is a potent drug, but in the case of babies who need surgery, there aren't many alternatives.
Dr. Dusica Bajic, a researcher at Boston Children's Hospital, presented a small study at the Society for Neuroscience 2017 meeting, that suggested newborns who underwent a surgical procedure and as a result had to have anesthesia and long periods of sedation were at risk for abnormal brain changes. For consistency, the study subjects were all newborns who had surgery to repair a relatively common congenital structural abnormality in the gastrointestinal tract.
While the surgery the babies had was necessary and even life-saving, the effects of the sedation that was required are troubling. The babies all underwent MRI scans of the brain. Those results showed multiple brain abnormalities in the grey and white matter of the brain. These kinds of abnormalities are often seen in children who have developmental delays in language and other cognitive areas. The scans also showed more brain fluid in the ventricles of the brain as compared to healthy infants. While this fluid is necessary for neurons to thrive, too much can cause intracranial pressure to rise, squeezing the brain and impacting function. The study showed that the higher the dose of opioid sedatives a child received, the more severe the abnormalities.
It's well documented that babies who are born to mothers who used opioid drugs have brain abnormalities, but in these babies, the exposure was a result of necessary medical treatment, so it's important to understand the risks in neonatal surgeries. The FDA has declared that general anesthesia and sedation for babies undergoing surgery is safe, but their guidelines are based on animal studies, not human.
There were some issues with the study including the size and the control group. Only nine newborns were studied, and the control group consisted of healthy infants. Bajic addressed this in a press statement quoted in the Daily Mail, saying, "The future research needs to include [a] surgical control group, which would be the children with a similar type of surgery but in the absence of prolonged sedation. Other studies should be done to see if antibiotic use, the absence of normal environmental stimuli during sedation, an absence of normal feeding, etc. can play a role instead. We do not want to raise unnecessary concern with parents at this early stage of research especially since these babies undergo life-saving surgeries."
The video included here has more information on the study, take a look.