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Rocuronium for nonemergent intubation of term and preterm infants

Journal of Perinatology volume 31, pages 38–43 (2011)Cite this article

Subjects

Abstract

Objective:

The aim of this study was to analyze clinical characteristics of rocuronium as premedication for nonemergent intubation in infants.

Study Design:

Preterm infants requiring nonemergent intubation were randomized to receive atropine and fentanyl with or without rocuronium. Outcomes, patient characteristics and intubator's experience were noted. Onset, duration and degree of clinical paralysis were recorded for rocuronium group and for older infants receiving rocuronium per unit protocol.

Result:

Forty-four intubations were randomized (20 rocuronium, 24 control). Groups were similar in chronological and corrected gestational age, weight and intubator's experience. Successful intubation on first attempt was achieved in 35% of intubations under rocuronium vs 8% of controls; rocuronium was the only significant variable by logistic regression (odds ratio=0.052, P=0.029). Complete paralysis was reported in 80% of 57 rocuronium intubations; onset ranged from 14 to 178 s (65.9±43.4), and duration from 1 to 60 min (16.3±13.5).

Conclusion:

Rocuronium facilitated successful intubation and provided clinical paralysis quickly in most infants.

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Acknowledgements

We appreciate the cooperation of the nurses, respiratory therapists, and Ms Bonnie Kanzia of the Neonatal Intensive Care Unit of Loyola University Medical Center in completing our study. We especially thank the parents who allowed us to include their children in our research.

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Authors and Affiliations

  1. Division of Neonatology, Department of Pediatrics, Loyola University Medical Center, Maywood, IL, USA

    D M Feltman & M G Weiss

  2. Department of Pharmacy, Loyola University Medical Center, Maywood, IL, USA

    P Nicoski

  3. Department of Preventive Medicine, Loyola University Medical Center, Maywood, IL, USA

    J Sinacore

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  1. D M Feltman
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  2. M G Weiss
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  4. J Sinacore
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Correspondence to D M Feltman.

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Feltman, D., Weiss, M., Nicoski, P. et al. Rocuronium for nonemergent intubation of term and preterm infants. J Perinatol 31, 38–43 (2011). https://doi.org/10.1038/jp.2010.74

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