How Should Infants Be Sedated During Elective Intubation?

Atropine with propofol was equivalent to atropine with atracurium and sufentanil for intubation procedures but follow-up is needed to establish which regimen is safest.

It is now accepted that all newborn infants feel pain, and that endotracheal intubation should be performed with pain medications whenever possible. However, the optimal combination of drugs for young infants remains unknown.

Between 2002 and 2016, investigators in six French perinatal centers randomized 173 newborn infants (mean gestational age, 30.6 weeks) undergoing nonemergent nasotracheal intubation to premedication with atropine plus propofol or with atropine, atracurium and sufentanil plus propofol. The groups had similar rates (59.6% vs. 65.9%, P=0.38) of prolonged desaturation events (the primary outcome, defined as SpO₂ of less than 80% for 60 seconds). The mean duration of intubation was longer in the atropine-propofol group than …

Reviewing Author

Robin H. Steinhorn, MD

Disclosures

Consultant/Advisory BoardActelion Pharmaceuticals

Editorial BoardsJournal of Pediatrics

Leadership Positions in Professional SocietiesAmerican Pediatric Society (President); American Board of Pediatrics (Board of Directors)

Robin H. Steinhorn, MD

Disclosures

Consultant/Advisory BoardActelion Pharmaceuticals

Editorial BoardsJournal of Pediatrics

Leadership Positions in Professional SocietiesAmerican Pediatric Society (President); American Board of Pediatrics (Board of Directors)

How Should Infants Be Sedated During Elective Intubation?

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Reviewing Author