Premedication for Neonatal Intubation

Barrington, Keith J.; Byrne, Paul

doi:10.1055/s-2007-993928

Cited by 66 publications

(53 citation statements)

References 10 publications

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“…Barrington and Byrne 9 reported similar success in neonates using atropine, fentanyl and succinylcholine. However, serious potential adverse effects of succinylcholine have shifted interest to nondepolarizing neuromuscular blocking agents as safer alternatives.…”

Section: Introductionmentioning

confidence: 86%

Rocuronium for nonemergent intubation of term and preterm infants

et al. 2010

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Objective: The aim of this study was to analyze clinical characteristics of rocuronium as premedication for nonemergent intubation in infants.Study Design: Preterm infants requiring nonemergent intubation were randomized to receive atropine and fentanyl with or without rocuronium. Outcomes, patient characteristics and intubator's experience were noted. Onset, duration and degree of clinical paralysis were recorded for rocuronium group and for older infants receiving rocuronium per unit protocol.Result: Forty-four intubations were randomized (20 rocuronium, 24 control). Groups were similar in chronological and corrected gestational age, weight and intubator's experience. Successful intubation on first attempt was achieved in 35% of intubations under rocuronium vs 8% of controls; rocuronium was the only significant variable by logistic regression (odds ratio ¼ 0.052, P ¼ 0.029). Complete paralysis was reported in 80% of 57 rocuronium intubations; onset ranged from 14 to 178 s (65.9±43.4), and duration from 1 to 60 min (16.3 ± 13.5).Conclusion: Rocuronium facilitated successful intubation and provided clinical paralysis quickly in most infants.

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Section: Introductionmentioning

confidence: 86%

Rocuronium for nonemergent intubation of term and preterm infants

et al. 2010

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“…31 When used alone, fentanyl and other synthetic opioids have been associated with acute chest wall rigidity in both preterm and term infants, which can significantly impair ventilation. 30 However, this adverse effect may be related to dose and rapid delivery and can be prevented by slow infusion of an appropriate dose and overcome with muscle relaxant 50 or reversed with naloxone. 30 Succinylcholine has been reported to have rare serious adverse effects in children, including hyperkalemia, myoglobinemia, and cardiac arrhythmias.…”

Section: Adverse Effectsmentioning

confidence: 99%

Premedication for Nonemergency Endotracheal Intubation in the Neonate

Kumar¹,

Denson²,

Mancuso³

et al. 2010

Pediatrics

190

211

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“…Fast-acting opioids, such as fentanyl (152)(153)(154), are probably more appropriate than morphine (155,156). Despite encouraging results, the paucity of available data for alfentanil (157) and remifentanil (119,158) imposes limitations on the use of these drugs.…”

Section: Practical Recommendations For Endotracheal Intubationmentioning

confidence: 99%

Use of Analgesic and Sedative Drugs in the NICU: Integrating Clinical Trials and Laboratory Data

et al. 2010

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Recent advances in neonatal intensive care include and are partly attributable to growing attention for comfort and pain control in the term and preterm infant requiring intensive care. Limitation of painful procedures is certainly possible, but most critically ill infants require unavoidable painful or stressful procedures such as intubation, mechanical ventilation, or catheterization. Many analgesics (opioids and nonsteroidal anti-inflammatory drugs) and sedatives (benzodiazepines and other anesthetic agents) are available but their use varies considerably among units. This review summarizes current experimental knowledge on the effects of sedative and analgesic drugs on brain development and reviews clinical evidence that speaks for or against the use of common analgesic and sedative drugs in the NICU but avoids any discussion of anesthesia during surgery. Risk/benefit ratios of intermittent boluses or continuous infusions for the commonly used sedative and analgesic agents are discussed in the light of clinical and experimental studies. The limitations of extrapolating experimental results from animals to humans must be considered while making practical recommendations based on the currently available evidence.

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Premedication for Neonatal Intubation

Cited by 66 publications

References 10 publications

Rocuronium for nonemergent intubation of term and preterm infants

Rocuronium for nonemergent intubation of term and preterm infants

Premedication for Nonemergency Endotracheal Intubation in the Neonate

Use of Analgesic and Sedative Drugs in the NICU: Integrating Clinical Trials and Laboratory Data

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