Atropine, fentanyl and succinylcholine for non-urgent intubations in newborns
Atropine, fentanyl and succinylcholine for non-urgent intubations in newborns
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阿托品、芬太尼和琥珀胆碱用于新生儿非紧急插管
DOI：
10.1136/adc.2008.146068
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发表时间：
2009
期刊：
影响因子：
--
通讯作者：
I. Gaboury
中科院分区：
文献类型：
--
作者：
B. Lemyre;Rui Cheng;I. Gaboury
目的：描述使用阿托品芬太尼+/−琥珀胆碱作为术前用药时的插管条件和不良事件。设计：前瞻性观察研究，作为质量改进计划的一部分。背景：在加拿大渥太华的两个3级新生儿重症监护病房。患者：60名婴儿，中位妊娠27周，出生时1023 g。干预措施：婴儿在插管前接受阿托品、芬太尼+/−琥珀胆碱。琥珀酰胆碱用于所有34周以内的婴儿，对于34周以内的婴儿，由医生决定。主要结局指标：主要结局是尝试次数。次要结局是接受和未接受琥珀胆碱的婴儿的尝试次数和插管条件以及安全性。结果：平均尝试次数为2次。91.7%的人有良好或优秀的条件。接受琥珀胆碱的婴儿尝试的中位次数低于未接受琥珀胆碱的婴儿（1 vs 2）。未发现严重不良事件。2例芬太尼给药后袋式和面罩通气困难。结论：在新生儿非紧急插管前使用阿托品、芬太尼和琥珀酰胆碱导致尝试次数少，插管条件良好，无不良事件。
Objective: Describe intubation conditions and adverse events when using atropine fentanyl +/− succinylcholine as premedication. Design: Prospective observational study, as part of a quality improvement initiative. Setting: Two level 3 neonatal intensive care units in Ottawa, Canada Patients: 60 infants, median 27 weeks gestation, 1023 g at birth were included. Interventions: Infants received atropine, fentanyl +/− succinylcholine prior to the intubation. Succinylcholine was given for all infants ⩾34 weeks and at the discretion of the physician for those <34 weeks. Main outcome measures: 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. Conclusion: 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.