Atropine, fentanyl and succinylcholine for non-urgent intubations in newborns.
OBJECTIVE
Describe intubation conditions and adverse events when using atropine fentanyl +/- succinylcholine as premedication.


METHODS
Prospective observational study, as part of a quality improvement initiative.


METHODS
Two level 3 neonatal intensive care units in Ottawa, Canada


METHODS
60 infants, median 27 weeks gestation, 1023 g at birth were included.


METHODS
Infants received atropine, fentanyl +/- succinylcholine prior to the intubation. Succinylcholine was given for all infants > or =34 weeks and at the discretion of the physician for those <34 weeks.


METHODS
The primary outcome was the number of attempts. Secondary outcomes were number of attempts and intubation conditions in infants who received and those who did not receive succinylcholine and safety.


RESULTS
The median number of attempts was 2. 91.7% had excellent or good conditions. The median number of attempts for infants who received succinylcholine was lower (1 vs 2) than those who did not. No serious adverse events were noted. 2 cases of difficult bag and mask ventilation after administration of fentanyl were noted.


CONCLUSIONS
Atropine, fentanyl and succinylcholine before non-urgent intubations in newborns has led to a low number of attempts and good intubation conditions with no adverse events.
Lemyre
B
B
University of Ottawa, Ottawa, Ontario, Canada. blemyre@toh.on.ca
Cheng
R
R
Gaboury
I
I
D000759:Adjuvants, Anesthesia / Q000627:therapeutic use; D000367:Age Factors; D000701:Analgesics, Opioid / Q000627:therapeutic use; D001285:Atropine / Q000627:therapeutic use; D002170:Canada; D005283:Fentanyl / Q000627:therapeutic use; D005865:Gestational Age; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D007363:Intensive Care Units, Neonatal; D015931:Intensive Care, Neonatal / Q000379:methods; D007442:Intubation, Intratracheal / Q000009:adverse effects / Q000379:methods*; D009467:Neuromuscular Depolarizing Agents / Q000009:adverse effects / Q000627:therapeutic use*; D011292:Premedication / Q000009:adverse effects / Q000379:methods*; D011446:Prospective Studies; D013390:Succinylcholine / Q000009:adverse effects / Q000627:therapeutic use*; D016896:Treatment Outcome
D000759:Adjuvants, Anesthesia; D000701:Analgesics, Opioid; D009467:Neuromuscular Depolarizing Agents; D001285:Atropine; D013390:Succinylcholine; D005283:Fentanyl