Transcutaneous auricular neurostimulation for neonatal abstinence syndrome

新生儿禁欲综合症(NAS)是一种婴儿在接触到毒品后出现戒断的情况 处方药或非处方药，如子宫内的美沙酮或海洛因。NAS婴儿表现出过度易怒 中枢神经系统以及呼吸系统、胃肠道和自主神经症状。这些症状 通常出现在出生后48至72小时内。截至2012年，每25分钟就有一名患有NAS的婴儿出生 美国，占全国医疗保健支出的15亿美元以上。2000-2012年间，全国 新生儿出生缺陷发生率从1.2/1000提高到5.8/1000，上升了383%。这些婴儿经常需要 在新生儿重症监护病房(NICU)住院，平均住院25天 治疗费用为6.6万美元。 目前，没有全国性的护理标准来管理NAS。NAS的治疗通常遵循 以口服吗啡溶液的药物治疗为基础的多模式疗法，主要与镇静剂相结合。 这种方法显然是有争议的，因为它会给新生儿带来额外的压力，因此需要一种 镇静剂。美国儿科学会建议尝试使用非药物 治疗，包括将婴儿放在黑暗和安静的环境中，包裹，摇晃，母乳喂养， 以及在频繁的小规模喂养中提供高卡路里营养等技术。当被利用时 适当地，这种非药物干预导致住院时间缩短， 治疗，以及需要药物治疗的婴儿百分比。 近年来，耳针作为NAS新生儿的辅助治疗方法已被研究。使用非- 使用传统针或手持激光的插入针灸(NIA)已经导致了一些NAS婴儿 在治疗过程中变得更加放松。虽然需要更深入的研究来评估NIA 作为NAS新生儿的一种有效的辅助疗法，早期的结果显示出挖掘耳穴的前景 治疗NAS的神经通路。 虽然针灸非常安全，而且不需要专门的设备，但这项技术的结果可能会有所不同 这在很大程度上取决于谁在应用这种疗法。我们建议开发一种经皮耳廓 神经刺激装置，帮助NAS婴儿从阿片类药物戒断中恢复，没有有害的副作用。这个 非侵入性的耳穴神经刺激装置将放置在耳朵周围(类似于助听器)和 刺激将通过皮肤传递。

Neonatal abstinence syndrome (NAS) is a condition in which infants undergo withdrawal after exposure to prescription or non-prescription opioids such as methadone or heroin in utero. NAS babies exhibit hyperirritability of the central nervous system and respiratory, gastrointestinal, and autonomic symptoms. These symptoms usually appear within 48 to 72 hours after birth. As of 2012, an infant with NAS was born every 25 minutes in the US, accounting for more than $1.5 billion in national healthcare expenditures. Between 2000–2012, national rates of NAS increased 383% from 1.2 per 1000 births to 5.8 per 1000 births. These infants frequently require hospital stay in a neonatal intensive care unit (NICU) with an average hospital stay of 25 days at an average treatment cost of $66K. Currently, no nationwide standard of care exists for managing NAS. Treatment of NAS usually follows a multimodal regime based on drug therapy with an oral morphine solution, mostly in combination with a sedative. This approach is clearly controversial as it can impart additional stress on the newborn, thus the need for a sedative. The American Academy of Pediatrics recommends attempting the use of non-pharmacologic treatment, which includes placing the infant in a dark and quiet environment, swaddling, rocking, breastfeeding, and providing high-calorie nutrition in frequent small feedings, among other techniques. When utilized appropriately, such non-pharmacological interventions have resulted in a reduction in length of stay, length of treatment, and percentage of infants requiring pharmacotherapy. Auricular acupuncture has recently been studids as an adjunctive therapy for NAS newborns. The use of non- insertive acupuncture (NIA) using traditional needles or a handheld laser has resulted in some of NAS babies becoming more relaxed during their course of treatment. While more indepth studies are needed to evaluate NIA as an effective adjunct therapy for NAS newborns, the early results show promise of tapping into the auricular neural pathways for treating NAS. While acupuncture is quite safe and requires no specialized equipment, the results of the technique can vary widely depending on who is applying the therapy. We propose to develop a transcutaneous auricular neurostimulation device to help NAS babies recover from opioid withdrawal without harmful side effects. The non-invasive, auricular neurostimulation device will be placed around the ear (similar to a hearing aid) and stimulation will be delivered transcutaneously.