Impact of PDA Closure Methodology on Peri-procedural Opioid Utilization in Preterm Neonates, a Cross-sectional Review in a Tertiary Pediatric Healthcare System.

Abstract Objective- To study the association between PDA closure methodology and peri-procedural opioid utilization in preterm neonates. Study Design –A retrospective cohort study comprising all premature neonates and infants with a hemodynamically significant PDA who underwent surgical ligation (SL) between February 2020 – December 2022 or transcatheter PDA closure (TCPC) between August 2020 – February 2023. Intra-procedural and post-procedural opioid use was systematically quantified and compared between the two groups before and after propensity score matching. Result – The study included 52 preterm infants in the SL group and 74 in the TCPC group. After propensity score matching, infants undergoing TCPC received significantly lower intraprocedural (4.33 vs 5.99 µg/kg, p = 0.037) and post-procedural (0.09 vs 0.32 mg/kg, p < 0.001) opioids. A significantly lower proportion of infants undergoing TCPC were exposed to post-procedural opioids (60.8% vs 92.3%, p = < 0.001). Conclusion – Transcatheter PDA device closure is associated with significantly lower neonatal opioid exposure.