title: Premedication for neonatal intubation: Current practice in Saudi Arabia.
abstract: BACKGROUND
  Despite strong evidence of the benefits of rapid sequence intubation in neonates, it is still infrequently utilized in neonatal intensive care units (NICU), contributing to avoidable pain and secondary procedure-related physiological disturbances.
  
  
  OBJECTIVE
  The primary objective of this cross-sectional survey was to assess the practice of premedication and regimens commonly used before elective endotracheal intubation in NICUs in Saudi Arabia. The secondary aim was to explore neonatal physicians' attitudes regarding this intervention in institutions across Saudi Arabia.
  
  
  METHODS
  A web-based, structured questionnaire was distributed by the Department of Pediatrics, Umm Al Qura University, Mecca, to neonatal physicians and consultants of 10 NICUs across the country by E-mail. Responses were tabulated and descriptive statistics were conducted on the variables extracted.
  
  
  RESULTS
  85% responded to the survey. Although 70% believed it was essential to routinely use premedication for all elective intubations, only 41% implemented this strategy. 60% cited fear of potential side effects for avoiding premedication and 40% indicated that the procedure could be executed more rapidly without drug therapy. Treatment regimens varied widely among respondents.
  
  
  CONCLUSIONS
  Rates of premedication use prior to non-emergent neonatal intubation are suboptimal. Flawed information and lack of unified unit policies hampered effective implementation. Evidence-based guidelines may influence country-wide adoption of this practice.
authors.affiliation: Department of Pediatrics, Umm Al Qura University, Mecca, Saudi Arabia ; International Medical Center, Jeddah, Saudi Arabia.
authors.forename: Rafat
authors.initials: R
authors.lastname: Mosalli
authors.forename: Lana
authors.initials: L
authors.lastname: Shaiba
authors.forename: Khalid
authors.initials: K
authors.lastname: Alfaleh
authors.forename: Bosco
authors.initials: B
authors.lastname: Paes
keywords: Endotracheal intubation; neonate; premedication; sedation