سامانه مدیریت نشریات علمی دانشگاه علوم پزشکی مشهد

Mussavi, Mirhadi, Ghojazadeh, Mortaza, dadakhani, Samayeh. (1401). Comparison of the Effect of Remifentanil Plus Atropine with Fentanyl and Remifentanil Alone on Preterm Infants’ Vital Signs in Non-emergency Intratracheal Intubation. , 13(4), 21-27. doi: 10.22038/ijn.2022.64315.2242
Mirhadi Mussavi; Mortaza Ghojazadeh; Samayeh dadakhani. "Comparison of the Effect of Remifentanil Plus Atropine with Fentanyl and Remifentanil Alone on Preterm Infants’ Vital Signs in Non-emergency Intratracheal Intubation". , 13, 4, 1401, 21-27. doi: 10.22038/ijn.2022.64315.2242
Mussavi, Mirhadi, Ghojazadeh, Mortaza, dadakhani, Samayeh. (1401). 'Comparison of the Effect of Remifentanil Plus Atropine with Fentanyl and Remifentanil Alone on Preterm Infants’ Vital Signs in Non-emergency Intratracheal Intubation', , 13(4), pp. 21-27. doi: 10.22038/ijn.2022.64315.2242
Mussavi, Mirhadi, Ghojazadeh, Mortaza, dadakhani, Samayeh. Comparison of the Effect of Remifentanil Plus Atropine with Fentanyl and Remifentanil Alone on Preterm Infants’ Vital Signs in Non-emergency Intratracheal Intubation. , 1401; 13(4): 21-27. doi: 10.22038/ijn.2022.64315.2242

Comparison of the Effect of Remifentanil Plus Atropine with Fentanyl and Remifentanil Alone on Preterm Infants’ Vital Signs in Non-emergency Intratracheal Intubation

Iranian Journal of Neonatology
مقاله 5، دوره 13، شماره 4، دی 2022، صفحه 21-27    اصل مقاله (692.37 K)
نوع مقاله: Original Article
شناسه دیجیتال (DOI): 10.22038/ijn.2022.64315.2242
نویسندگان
Mirhadi Mussavi* 1؛ Mortaza Ghojazadeh2؛ Samayeh dadakhani3
1Department of Pediatrics, Faculty of Medicine, University of Medical Sciences, Tabriz, Iran
2Research Center for Evidence Based Medicine (RCEBM), Tabriz University of Medical Sciences, Tabriz, Iran.
3Clinical Research Development Unit of Children Hospital, University of Medical Sciences, Tabriz, Iran.
چکیده
Background: Intratracheal intubation is associated with many side effects. Different groups of drugs have been used to control these side effects, but there is still no consensus on the most suitable drugs.
This study aimed to compare the effect and possible side effects of fentanyl, remifentanil, and atropine plus remifentanil on the vital signs of preterm infants in non-emergency intratracheal intubation.
Methods: In this randomized clinical trial study, 75 neonates with a gestational age of 27 to 34 weeks who required temporary intubation were included in the study and divided into three groups by computer randomization. Then, the effects and possible side effects of remifentanil, fentanyl, and remifentanil with atropine on clinical parameters (blood pressure, heart rate, and arterial oxygen saturation) were investigated.
Results: A total of 75 neonates with a mean gestational age of 30.4 weeks were studied. There was no significant difference between study groups in terms of changes in the systemic blood pressure and heart rate, but the mean oxygen saturation in all three groups was significantly different at different measurement times (P-value: 0.036). The group receiving remifentanil plus atropine reported minimal changes in oxygen saturation and their oxygen saturation was significantly higher than the other groups 30 min after extubation.
Conclusion: The use of remifentanil with atropine in preterm infants is associated with lower changes in oxygen saturation and higher arterial oxygen saturation 30 min after extubation. The use of remifentanil or remifentanil with atropine or fentanyl has no significant effect on the blood pressure and heart rate of neonates in non-emergency intratracheal intubation.
 
 
کلیدواژه‌ها
Atropine؛ Endotracheal intubation؛ Fentanyl؛ Premature infant؛ Remifentanil
مراجع
  1. Hosseini M, Mirnia K, Ghojazadeh M,et al. Remifentanil versus Fentanyl for pain control during elective endotracheal intubation for surfactant administration in preterm infants. Journal of Pediatric and Neonatal Individualized Medicine (JPNIM).2018; 7(2): e070214-e070214.
  2. Byrne, E, MacKinnon R. Should premedication be used for semi-urgent or elective intubation in neonates? Archives of Disease in Childhood.2006; 91(1): 79-83.
  3. Kumar, P, Denson S,Mancuso, T J. Premedication for nonemergency endotracheal intubation in the neonate. Pediatrics 2010; 125(3): 608-615.
  4. Lemyre, B R, Cheng Gaboury, I. Atropine, fentanyl and succinylcholine for non-urgent intubations in newborns. Archives of Disease in Childhood-Fetal and Neonatal Edition.2009; 94(6): 439-442.
  5. Barrington, KJ. Premedication for endotracheal intubation in the newborn infant. Pediatrics & Child Health. 2011; 16(3):159-164.
  6. LeoneTA, et al. Impact of premedication on neonatal intubations by pediatric and neonatal trainees. Journal of Perinatology. 2014; 34(6): 458-460.
  7. Hall R W Annand, KJS. Pain management in newborns. Clinics in Perinatology. 2014 ;41(4): 895-924.
  8. Maheshwari R, Tracy M, Badawi N, et al. Neonatal endotracheal intubation: how to make it more babies friendly. Journal of Pediatrics and Child Health. 2016; 52(5): 480-486.
  9. Dempsey E M, Al Hazzani F, Faucher D,et al. Facilitation of neonatal endotracheal intubation with mivacurium and fentanyl in the neonatal intensive care unit. Archives of Disease in Childhood-Fetal and Neonatal Edition. 2006; 91(4): 279-F282.
  10. Allen K A. Premedication for neonatal intubation: which medications are recommended and why? Advances in Neonatal Care. 2012; 12(2): 107.
  11. Bhutada,et al. Randomized controlled trial of thiopental for intubation in neonates. Archives of Disease in Childhood-Fetal and Neonatal Edition. 2000; 82(1): F34-F37.
  12. Venkatesh V, Ponnusamy V, Anandaraj,et al. Endotracheal intubation in a neonatal population remains associated with a high risk of adverse events. European Journal of Pediatrics. 2011; 170(2): 223-227.
  13. Simon L,Trifa M, Mokhtari,et al. Premedication for tracheal intubation: a prospective survey in 75 neonatal and pediatric intensive care units. Critical Care Medicine. 2004; 32(2): 565-568.
  14. Mirhadi Mussavi, Khairollah Asadollahi, et al. Application of Lidocaine Spray for Tracheal Intubation in Neonates - A Clinical Trial Study. Iran J Pediatr. 2015 February; 25(1):245.
  15. Duncan H, Zurick J,Wolf A. Should we reconsider awake neonatal intubation? A review of the evidence and treatment strategies. Pediatric Anesthesia. 2001; 11(2): 135-145.
  16. Silva P, Gomez R, Marcatto,et al. Morphine versus remifentanil for intubating preterm neonates. Archives of Disease in Childhood-Fetal and Neonatal Edition. 2007;92(4): 293-294.
  17. Choong K, K AlFaleh,et al. Remifentanil for endotracheal intubation in neonates: a randomized controlled trial. BMJ. 2010; 95(2):80-84
  18. Giannantonio, C, M Sammartino, E Valente,et al. Remifentanil analog sedation in preterm newborns during mechanical ventilation. Acta Paediatrica. 2009; 98(7):1111-1115.
  19. Oei R Hari, Butha K Lui. Facilitation of neonatal nasotracheal intubation with premedication: a randomized controlled trial. Journal of Pediatrics and Child Health. 2002; 38(2):146-150.
  20. Clément Chollat, Arielle Maroni, Marie-Stephanie Aubelle, et al. Efficacy and safety aspects of remifentanil sedation for intubation in neonates: a retrospective study. Front. Pediatr. 2019; 07
  21. Badiee, Z, Vakiliamini, M, Mohammadizadeh, M. Remifentanil for endotracheal intubation in premature infants: a randomized controlled trial. J Res Pharm Pract. 2013; 2(2): 75–82
  22. Kari D, Roberts MD, Tina A, Leone MD, William H,et al. Premedication for emergent neonatal intubations: a randomized, Controlled trial comparing atropine and fentanyl to atropine, fentanyl, and mivacurium. PEDIATRICS. 2006;118(4):1583-91
  23. Friesen R H, Honda AT,Thieme, RE. Changes in anterior fontanel pressure in preterm neonates during tracheal intubation. Anesthesia and Analgesia.1987; 66(9), 874-878.
  24. Jones, P. The therapeutic value of atropine for critical care intubation. Archives of Disease in Childhood. 2016; 101(1), 77-80.
  25. Barrington, KJ, Finer,N Etches, PC. (1989). Succinylcholine and atropine for premedication of the newborn infant before nasotracheal intubation: a randomized, controlled trial. Critical Care Medicine, 17(12), 1293-1296.
  26. Pereira e SilvaY, Gomez RS, Marcatto J,et al. Morphine versus remifentanil for intubating preterm neonates. Arch Dis Child Fetal Neonatal Ed. 2007; 92(4): F293–F294.
  27. Crawford MW, Hayes J, Tan JM. Dose-response of remifentanil for tracheal intubation in infants. Anesth Analg. 2005;100(6):1599–1604.
  28. Yankui H., Qingxiang C., Huihui L., et al. Remifentanil inhibits the inflammatory response of BV2 microglia and protects PC12 cells from damage caused by microglia activation. Bioengineered, 2022;. 13(5):13944–13955.
  29. Yingjie, JW, Li, JJ. Protective role of fentanyl in lipopolysaccharide induced neuroinflammation in BV2 cells. Experimental and Therapeutic Medicine. 2018; (9),3740-3744.
 

 

 

 

 

آمار
تعداد مشاهده مقاله: 307
تعداد دریافت فایل اصل مقاله: 363