Document Detail


Facilitation of neonatal nasotracheal intubation with premedication: a randomized controlled trial.
MedLine Citation:
PMID:  12030995     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To determine if premedication reduces the time and number of attempts by junior medical staff to achieve nasotracheal intubation in neonates. The experimental design was a non-blinded randomized controlled pilot trial. The setting was a perinatal centre in a university teaching hospital. METHODS: Twenty infants (within the ranges of 25-40 weeks gestation, 650-3660 g and 1 h to 81 days of age) requiring semi-urgent intubation were randomized to either premedication with morphine, atropine and suxamethonium, or to awake intubation. RESULTS: There were no significant differences between the two groups in regard to prior intubation experience of the staff or infant weight or gestation. The intubation procedure, including intervening events, to completion was significantly faster in premedicated infants (median 60 s vs 595 s; P = 0.002) who were intubated at a younger postnatal age. It took twice as many attempts to intubate a conscious infant (median 2 vs 1; P = 0.010). There was a greater decrease in heart rate from the baseline in the unpremedicated group (mean 68 b.p.m. vs 29 b.p.m.; P = 0.017), but decreases in oxygen saturation were not different. Blood was observed in the oral and nasal passages after intubation in five of the awake infants and in one of the premedicated infants. CONCLUSIONS: The use of premedication reduces the total time and number of attempts taken to achieve successful nasotracheal intubation of neonates by junior medical staff under supervision.
Authors:
J Oei; R Hari; T Butha; K Lui
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Journal of paediatrics and child health     Volume:  38     ISSN:  1034-4810     ISO Abbreviation:  J Paediatr Child Health     Publication Date:  2002 Apr 
Date Detail:
Created Date:  2002-05-28     Completed Date:  2002-06-13     Revised Date:  2007-09-24    
Medline Journal Info:
Nlm Unique ID:  9005421     Medline TA:  J Paediatr Child Health     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  146-50     Citation Subset:  IM    
Affiliation:
Department of Newborn Care, Royal Hospital for Women, Randwick, Australia.
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MeSH Terms
Descriptor/Qualifier:
Analgesics, Opioid / administration & dosage
Atropine / administration & dosage
Australia
Heart Rate
Humans
Infant
Infant, Newborn
Intensive Care, Neonatal / methods*,  standards
Intubation, Intratracheal / methods*,  standards
Morphine / administration & dosage
Neuromuscular Depolarizing Agents / administration & dosage
Nose
Oxygen / blood
Parasympatholytics / administration & dosage
Pilot Projects
Premedication* / utilization
Succinylcholine / administration & dosage
Chemical
Reg. No./Substance:
0/Analgesics, Opioid; 0/Neuromuscular Depolarizing Agents; 0/Parasympatholytics; 306-40-1/Succinylcholine; 51-55-8/Atropine; 57-27-2/Morphine; 7782-44-7/Oxygen

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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