Conversion from prolonged intravenous fentanyl infusion to enteral methadone in critically ill children

Table 2 Conversion from intravenous fentanyl infusion to enteral methadone in rapid and slow conversion groups

	Rapid conversion groupa (n = 21)	Slow conversion groupb (n = 21)	P value
Dose of IV fentanyl infusion at initiation of enteral methadone, μg/kg per hour (median, IQR)	4 (3-4)	4.5 (3.6-7)	0.23
Adjustments in scheduled enteral methadone dose			< 0.05
Increase in dose	15	33
Decrease in dose	17	3
Opioid rescues in first 96 h of transition per patient (median, IQR)	3 (1-7)	12 (4-17)	< 0.05
0-24 h	0 (0-2)	3 (0-4)	< 0.05
24-48 h	1 (0-2)	2 (1-6)	0.02
48-72 h	0 (0-1)	1 (1-6)	0.01
72-96 h	0 (0-2)	2 (0-4)	0.12
Opioid rescues in first 96 h of transition by agent			< 0.05
Morphine	44	51
Fentanyl	51	210
Concomitant medications administered in first 96 h of transition (number of administrations)			0.6
Benzodiazepines	32	40
Clonidine	5	3
Barbiturates	2	8
NSAIDS	2	2
Neuromuscular blockers	4	6
Acetaminophen	9	10

^aRapid conversion group: Patients who were completely converted from IV fentanyl infusion directly to enteral methadone in 48 h or less;

^bSlow conversion group: Patients who were completely converted from IV fentanyl infusion directly to enteral methadone in more than 48 h. IV: Intravenous; IQR: Inter-quartile range; NSAIDS: Non-steroidal anti-inflammatory drugs.