Effect of premedication regimen on infant pain and stress response to endotracheal intubation

Objective: (1) Evaluate the effect of different medications on pain and stress in neonates during nonemergent endotracheal intubation; (2) determine whether gestational age affects medication use; (3) determine whether better sedation results in a decrease in the number of attempts and/or total time...

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Bibliographic Details
Published in:Journal of perinatology 2015-06, Vol.35 (6), p.415-418
Main Authors: Caldwell, C D, Watterberg, K L
Format: Article
Language:English
Subjects:
692/308
Analgesics, Opioid
Analysis
Biochemical markers
Blood
Blood glucose
Blood Glucose - analysis
Blood pressure
Care and treatment
Drug Combinations
Fentanyl
Gestational Age
Glucose
Humans
Infant
Infants
Infants (Newborn)
Intubation
Intubation, Intratracheal
Measurement
Medicine
Medicine & Public Health
Midazolam
Morphine
Neonates
original-article
Pain
Pain - prevention & control
Pediatric Surgery
Pediatrics
Preanesthetic Medication
Prospective Studies
Stimuli (Psychology)
Stress response
Stress, Physiological - drug effects
Stress, Physiological - physiology
Trachea
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Summary:Objective: (1) Evaluate the effect of different medications on pain and stress in neonates during nonemergent endotracheal intubation; (2) determine whether gestational age affects medication use; (3) determine whether better sedation results in a decrease in the number of attempts and/or total time for the procedure. Study design: Prospective observational study. Infant responses were measured using a clinical pain scale and blood glucose, a biochemical marker of acute stress. Result: A total of 166 infants were included, with adjusted gestational ages 24 to 44 weeks at the time of procedure. Premedication regimens included no medication (‘none,’ 27%), morphine (19%), morphine+midazolam (11%), fentanyl (14%), fentanyl+midazolam (19%) and midazolam alone (10%). Fentanyl+midazolam resulted in lower pain scores and less increase in blood glucose (both P
ISSN:0743-8346
1476-5543
DOI:10.1038/jp.2014.227