Premedication before intubation in UK neonatal units.
OBJECTIVE
To establish the extent and type of premedication used before intubation in neonatal units in the United Kingdom.


METHODS
A structured telephone survey was conducted of 241 eligible units. Units were subdivided into those that routinely intubated and ventilated babies (routine group) and those that transferred intubated and ventilated babies (transfer group).


RESULTS
Of the units contacted, 239 (99%) participated. Only 88/239 (37%) gave any sedation before intubating on the unit and only 34/239 (14%) had a written policy covering this. Morphine was used most commonly (66%), with other opioids and benzodiazepines used less frequently. Of the 88 units using sedation, 19 (22%) also used paralysis. Suxamethonium was given by 10/19 (53%) but only half of these combined it with atropine. Drug doses varied by factors of up to 200, even for commonly used drugs.


CONCLUSIONS
Most UK neonatal units do not sedate babies before intubating, despite evidence of physiological and practical benefits. Only a minority have written guidelines, which prohibits auditing of practice.
Whyte
S
S
Department of Anaesthetics, Liverpool Women's Hospital, Liverpool L8 7SS. sdwhyte@bigfoot.com
Birrell
G
G
Wyllie
J
J
D014151:Anti-Anxiety Agents / Q000008:administration & dosage; D001285:Atropine / Q000008:administration & dosage; D001569:Benzodiazepines; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage*; D007231:Infant, Newborn; D015931:Intensive Care, Neonatal / Q000458:organization & administration / Q000706:statistics & numerical data*; D007442:Intubation, Intratracheal / Q000706:statistics & numerical data*; D009020:Morphine / Q000008:administration & dosage; D009294:Narcotics / Q000008:administration & dosage; D019148:Neuromuscular Blockade; D009467:Neuromuscular Depolarizing Agents / Q000008:administration & dosage; D016134:Organizational Policy; D010276:Parasympatholytics / Q000008:administration & dosage; D010360:Patient Transfer / Q000706:statistics & numerical data; D017410:Practice Guidelines as Topic; D011292:Premedication / Q000706:statistics & numerical data*; D012121:Respiration, Artificial / Q000706:statistics & numerical data; D013390:Succinylcholine / Q000008:administration & dosage; D006113:United Kingdom / Q000453:epidemiology
D014151:Anti-Anxiety Agents; D006993:Hypnotics and Sedatives; D009294:Narcotics; D009467:Neuromuscular Depolarizing Agents; D010276:Parasympatholytics; D001569:Benzodiazepines; D009020:Morphine; D001285:Atropine; D013390:Succinylcholine