The effectiveness of premedication for endotracheal intubation in mechanically ventilated neonates. A systematic review.
CONCLUSIONS
Extrapolating information from the adult and pediatric literature suggests that awake intubation is probably inappropriate in most neonates. Because premedication attenuates the physiologic responses to intubation, its use is recommended. Adequately skilled staff who have a full understanding of the potential benefits and harms of the interventions used should perform intubation and the administration of premedication in neonates.


CONCLUSIONS
There is a need for well-designed and well-executed randomized controlled trials assessing the effectiveness and potential adverse effects of premedicated intubation in neonates. A valid pain assessment measure or approach should be used. Both short-term and long-term physiologic and clinical outcomes should be incorporated into the trial design.
Shah
Vibhuti
V
Department of Paediatrics, Mount Sinai Hospital, Faculty of Medicine, University of Toronto, 600 University Avenue, Toronto, ON M5G 1X5, Canada. vshah@mtsinai.on.ca
Ohlsson
Arne
A
D000700:Analgesics / Q000008:administration & dosage; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage; D007231:Infant, Newborn; D007442:Intubation, Intratracheal; D009466:Neuromuscular Blocking Agents / Q000008:administration & dosage; D010146:Pain / Q000517:prevention & control; D011292:Premedication; D012121:Respiration, Artificial
D000700:Analgesics; D006993:Hypnotics and Sedatives; D009466:Neuromuscular Blocking Agents