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The effect of using dexmedetomidine versus morphine as sedation on long-term neurodevelopmental outcomes of encephalopathic neonates undergoing therapeutic hypothermia

Journal of Perinatology volume 45, pages 1081–1086 (2025)Cite this article

Subjects

Abstract

Objective

To compare neurodevelopmental outcomes using Bayley Scales of Infant Development (BSID), between encephalopathic neonates undergoing therapeutic hypothermia (TH), sedated with either continuous dexmedetomidine or intermittent morphine.

Study design

Retrospective, observational cohort study including encephalopathic neonates born between 2014 - 2022 that underwent TH at two Regional Perinatal Centres, and completed neurodevelopmental follow-up assessments.

Results

There were no significant differences in demographics or short-term neurologic outcomes between morphine (n = 30) and dexmedetomidine (n = 32) groups. At 12 months, median motor composite scores (104 vs 98.5, p = 0.02) and median fine motor scaled scores (SS) (11 vs 10, p = 0.01) were significantly higher in the dexmedetomidine group. Median expressive language SS were slightly higher in the morphine group (11 v 10, p = 0.05). BSID scores at 18–24 months were similar.

Conclusion

This study supports the use of dexmedetomidine as first-line sedation agent during TH, given comparable 18–24 month neurodevelopmental outcomes.

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Data availability

The dataset that supports the findings of this study is not currently available in a public repository, but will be made available to reviewers or readers upon reasonable request, by contacting the corresponding author via e-mail.

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Acknowledgements

We would like to acknowledge the support of the Neonatology faculty, fellows, residents, APPs, nursing and ancillary staff in the Neonatal Comprehensive Care Programme, in addition to the Neonatal Intensive Care Units at Hassenfeld Childrens’ and Bellevue Hospitals.

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Authors and Affiliations

  1. Division of Neonatology, Department of Pediatrics, Hassenfeld Children’s Hospital at NYU Langone, 550 1st Avenue, New York, NY, 10016, USA

    Tatiana A. Nuzum, Sadaf H. Kazmi & Elena V. Wachtel

  2. Division of Neonatology, Department of Pediatrics, NYC H + H Bellevue Hospital, 462 1st Avenue, New York, NY, 10016, USA

    Tatiana A. Nuzum, Sadaf H. Kazmi & Elena V. Wachtel

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  1. Tatiana A. Nuzum
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  2. Sadaf H. Kazmi
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Contributions

TN, SK and EW all contributed to study design, data collection, analysis and interpretation of results, and manuscript preparation.

Corresponding author

Correspondence to Tatiana A. Nuzum.

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Competing interests

The authors declare no competing interests.

Ethics approval and consent to participate

This study was performed in accordance with the Declaration of Helsinki. The study was approved by our local institutional review boards prior to study conduct (NYU Langone Health Office of Science and Research Institutional Review Board – ref #i22-01180, Bellevue Hospital Institutional Review Board – ref STUDY00003730). Informed consent was not required, as this study includes a retrospective sample.

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Nuzum, T.A., Kazmi, S.H. & Wachtel, E.V. The effect of using dexmedetomidine versus morphine as sedation on long-term neurodevelopmental outcomes of encephalopathic neonates undergoing therapeutic hypothermia. J Perinatol 45, 1081–1086 (2025). https://doi.org/10.1038/s41372-025-02227-y

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