Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/33507
Title: The effect of age on clinical dose equivalency of fentanyl and morphine analgosedation in mechanically ventilated patients: Findings from the ANALGESIC trial.
Austin Authors: Casamento, Andrew ;Ghosh, Angajendra;Serpa Neto, Ary ;Young, Marcus ;Lawrence, Mervin;Taplin, Christina;Eastwood, Glenn M ;Bellomo, Rinaldo 
Affiliation: Intensive Care
Department of Intensive Care, Northern Hospital, Melbourne, Australia; Department of Critical Care, University of Melbourne, Melbourne, Australia; Department of Medical Education, University of Melbourne, Melbourne, Australia.
Department of Critical Care, University of Melbourne, Melbourne, Australia; Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia; Data Analytics Research & Evaluation (DARE) Center, University of Melbourne and Austin Hospital, Melbourne, Australia; Department of Critical Care Medicine, Hospital Israelita Albert Einstein, Sao Paulo, Brazil.
Department of Critical Care, University of Melbourne, Melbourne, Australia.
Issue Date: Mar-2024
Date: 2023
Publication information: Australian Critical Care : Official Journal of the Confederation of Australian Critical Care Nurses 2024-03; 37(2)
Abstract: The dose equivalency of fentanyl vs. morphine is widely considered to be approximately 1:100. However, little is known about the effect of age on this ratio when these agents are used as infusions for analgosedation. To assess the impact of age on the clinical dose equivalency of fentanyl and morphine when used as infusions for analgosedation in mechanically ventilated intensive care unit patients. We performed a post hoc analysis of the Assessment of Opioid Administration to Lead to Analgesic Effects and Sedation in Intensive Care (ANALGESIC) cluster randomised crossover trial of fentanyl and morphine infusions for analgosedation. Dose and analgosedative clinical equivalency of fentanyl and morphine were assessed by age and by using different body-size descriptors. We studied 663 patients (338 fentanyl, 325 morphine). Median (interquartile range) hourly dose of fentanyl and morphine were 58.1 (40.0-89.2) mcg and 3400 (2200-5000) mcg, respectively. The ratio of total dose of fentanyl:morphine was 1:93 in the 18- to 29-year-old group and 1:25 in the ≥80-year-old group (p = 0.015), respectively, with fentanyl becoming relatively less clinically effective as age increased. This effect was also seen when comparing dosing by different body-size descriptors with the strongest age-related change when using body surface area as body-size descriptor (p = 0.009). The analgosedative clinical dose equivalency of fentanyl vs. morphine is heterogeneous when used as infusions for analgosedation, with fentanyl becoming relatively less clinically effective as age increases. This information can help guide prescription of these agents during transition from one agent to the other in critically ill patients.
URI: https://ahro.austin.org.au/austinjspui/handle/1/33507
DOI: 10.1016/j.aucc.2023.07.001
ORCID: 
Journal: Australian Critical Care : Official Journal of the Confederation of Australian Critical Care Nurses
PubMed URL: 37574387
Type: Journal Article
Subjects: Analgosedation
Dose equivalency
Fentanyl
Mechanical ventilation
Morphine
Appears in Collections:Journal articles

Show full item record

Page view(s)

56
checked on Oct 10, 2024

Google ScholarTM

Check


Items in AHRO are protected by copyright, with all rights reserved, unless otherwise indicated.