Rocuronium for nonemergent intubation of term and preterm infants.
OBJECTIVE
The aim of this study was to analyze clinical characteristics of rocuronium as premedication for nonemergent intubation in infants.


METHODS
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.


RESULTS
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=0.052, P=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).


CONCLUSIONS
Rocuronium facilitated successful intubation and provided clinical paralysis quickly in most infants.
Division of Neonatology, Department of Pediatrics, Loyola University Medical Center, Maywood, IL, USA. DFeltman@northshore.org
D M
DM
Feltman
M G
MG
Weiss
P
P
Nicoski
J
J
Sinacore
D000732:Androstanols / Q000009:adverse effects / Q000627:therapeutic use*; D001145:Arrhythmias, Cardiac / Q000139:chemically induced; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D007442:Intubation, Intratracheal / Q000379:methods*; D016015:Logistic Models; D008297:Male; D003473:Neuromuscular Nondepolarizing Agents / Q000009:adverse effects / Q000627:therapeutic use*; D016017:Odds Ratio; D000077123:Rocuronium; D047929:Term Birth; D013997:Time Factors; D016896:Treatment Outcome
D000732:Androstanols; D003473:Neuromuscular Nondepolarizing Agents; D000077123:Rocuronium