• Pain physician · Mar 2014

    Review

    Long-term neuropsychological effects of opioid use in children: a descriptive literature review.

    • Gaurav Jain, Vijaita Mahendra, Sarita Singhal, Kristina Dzara, Trinadha R Pilla, Renee Manworren, and Alan D Kaye.
    • Division of Pain Medicine, Department of Anesthesiology, University of Pittsburgh Medical Center, Pittsburgh, PA; Department of Psychology, Temple University, Philadelphia, PA.
    • Pain Physician. 2014 Mar 1;17(2):109-18.

    BackgroundUse of opioids in the management of pain and its consequences in children presents a substantial challenge. A significant concern in pediatric pain management is the long-term neuropsychological consequences of opioids.ObjectivesThe authors aim to provide a descriptive review of the current literature surrounding the neuropsychological impact of opioid use in children, along with possible extrapolations from their use in adults and animal models.Study DesignSystematic review of published literature.SettingVarious universities in the United States.MethodsThe electronic review for papers published between January 1992 and December 2012 was conducted using Medline/Pubmed, PsychInfo, CINAHL, the Cochrane Library database, and Google Scholar.ResultsFindings assessing pediatric pain patients treated with opioids demonstrated no significant differences in intelligence, behavior, vocabulary, or motor skills. One study reported a decrease in a visuo-constructional ability, which measured higher order executive function. Studies from prenatal illicit opioid exposure found poorer performance on measures of language, verbal ability, mathematics, reading, impulse control, and school readiness skills. The literature from adult prescribed opioid users has mixed results. Some showed impairment in the neuropsychological domains of memory, decision-making, attention, concentration, information processing, psychomotor speed, visual special skills, and hand-eye coordination, while others found no differences or revealed improved perceptual-cognitive status, possibly due to the removal of pain as a stressor.LimitationsVery few studies looked into the long term neuropsychological and cognitive effects of the opioids in pediatric population. In an attempt to extrapolate from other groups, this review also included literature from adult patients, prenatal opioid exposure, and animal studies.ConclusionOpioid medications have the potential to produce long-lasting neuropsychological side effects. However, given the negative consequences of untreated pain, the potential benefit may offset their risk. More studies are needed to clarify this complex interaction.

      Pubmed     Free full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…