Abstract
Purpose: The purpose of this project was to determine if the addition of clonidine as an adjunct to morphine in the treatment of NAS, reduces length of stay in the NICU. To shorten the length of time in the hospital, the duration of treatment must be shortened. Prior to the addition of clonidine to morphine, the hospital’s treatment plan was morphine sulfate every 3 hours, with the addition of phenobarbital nightly if needed. The wean off morphine had been very slow for many infants, and they were in the NICU for weeks to months. The goal was to initiate clonidine to expedite the weaning of morphine more safely, and in turn reduce their length of stay.|Background: In the United States, there was a 383% increase in the number of infants born with NAS from 1999-2013, which means approximately 1 infant who will withdraw from drugs is born every 25 minutes. NAS is a complex and serious syndrome that presents as irritability, sweating, lack of coordination to eat, diarrhea, vomiting, weight loss, central nervous system instability, fever, tremors, increased tone, and if not treated adequately seizures. These symptoms are painful and put the infant at risk for failure to thrive and even death. Not only are there short and long-term implications to the infants, but NAS costs the government millions of dollars each year. In 2012, there was 1.5 billion dollars in hospital charges related to NAS, and of that 80% or 1.2 billion dollars were paid by the US government Medicaid program.|Setting: Data was collected on all infants admitted with NAS to a level III NICU in Madison Wisconsin.|Methods: A retrospective chart review was done on all infants admitted to the NICU from January to 2018 to January 2019. Data collected included gender, gestational age, length of stay, and pharmacological treatment received.|Results: Overall there were 19 infants in the study. There was a reduced length of stay as compared to previous years. In 2018 the length of stay was 25.3 days as compared to 2017 (27.3 days) and 2016 (28.9 days).|Conclusion: While there was an observed reduction in the overall length of stay in the NICU, there was also a reduced number of infants admitted to the NICU for NAS as compared to the previous years, therefore the data analysis could be limited. Overall clonidine was a safe adjunct to morphine, as there were no adverse effects reported. However, more data needs to be collected to determine if clonidine as an adjunct to morphine helps reduce length of stay in the NICU.