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Wiley InterScience | ||||||
  Clinical and Experimental Pharmacology and PhysiologyVolume 26 Issue 11, Pages 920 - 926 Published Online: 24 Dec 2001 Journal compilation © 2010 Blackwell Publishing Asia Pty Ltd
Abstract | References | Full Text: HTML, PDF (Size: 304K) | Related Articles | Citation Tracking  SEDATION WITH PROMETHAZINE PROFOUNDLY AFFECTS SPONTANEOUS AIRWAY PROTECTION IN SLEEPING NEONATAL PIGLETS §Present address: Department of Veterinary Clinical Sciences, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA 19104-6010, USA. Copyright 1999 Blackwell Science Asia Pty. Ltd. KEYWORDS apparent life-threatening events • arousal • gastro-oesophageal reflux • phenothiazines • sleep apnoea • Sudden Infant Death Syndrome • swallowing ABSTRACTSUMMARY1. Phenothiazine use in infants has been implicated in apparent life-threatening events, sleep apnoea and Sudden Infant Death Syndrome. 2. The aim of this study was to investigate the cumulative effects of a commonly used antihistamine medication containing promethazine on airway protective mechanisms and cardiorespiratory responses in 42 healthy neonatal piglets (21 naturally sleeping, 21 sedated sleeping). 3. Sedated piglets were given 1.5 mg/kg, p.o., promethazine 2 h prior to each recording session. Control animals slept naturally with no sedative given. On three consecutive days in all piglets, physiological recordings were made during sleep; on at least one of these days, simultaneous physiological and radiological observations were made. 4. Following sedation, sleep time and time in active sleep were increased significantly (P < 0.01). The spontaneous occurrence of swallowing, arousal, body movement, gastro-oesophageal reflux and apnoea was compared between naturally and sedated sleeping piglets. Sedation with promethazine significantly decreased the spontaneous occurrence of swallowing (P < 0.05) and arousal (P < 0.05) and increased the occurrence of both central (P < 0.05) and obstructive sleep apnoea (P < 0.0001). 5. By the third day, a cumulative effect of promethazine was seen; the rate of swallowing and body movement significantly decreased (P < 0.01). 6. In summary, a low dose of promethazine profoundly altered sleep characteristics, airway protective mechanisms and cardiorespiratory responses in normal healthy sleeping piglets. Continued use of promethazine over several days may attenuate airway protective mechanisms to a potentially life-threatening degree. Our findings support continued caution in the use of promethazine-containing medications for the sedation of infants. | 
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