Efficacy and Safety Aspects of Remifentanil Sedation for Intubation in Neonates: A Retrospective Study

Chollat, Clément; Maroni, A.; Aubelle, Marie‐Stéphanie; Guillier, Cyril; Patkaï, Juliana; Zana‐Taïeb, Elodie; Keslick, Aurélie; Torchin, Héloïse; Jarreau, Pierre‐Henri

doi:10.3389/fped.2019.00450

Cited by 7 publications

(5 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Indeed, it does not seem appropriate to consider achieving general anesthetic levels with opioids alone. When combined with midazolam or propofol, 1 mcg/kg remifentanil appears to be sufficient for quality sedation without side effects (Chollat et al, 2019). Omara et al, (2019), in their study said that the potential side effects of remifentanil cannot occur with proper use.…”

Section: Discussionmentioning

confidence: 99%

“…In a retrospective study by Chollat et al, (2019), they observed that continuous administration of remifentanil after a bolus of atropine led to favorable intubation conditions for 87% of neonatal patients, although side effects included chest wall stiffness (11%), breathing problems (9%) , and laryngospasm (2%). occurred in 22% of procedures.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Comparison of The Effectiveness of Remifentanyl versus Fentanyl in Pediatric Undergoing Methotrexate Therapy

Purwoko¹,

Putro²,

Pamungkas³

et al. 2022

INDONES J MED

View full text Add to dashboard Cite

Background: Anesthesia procedure is routinely performed for some painful pediatric oncologic procedures such as lumbar puncture (LP) and bone marrow examination (BME). Several studies mentioned that fentanyl and remifentanyl are often used as anesthetic agent of this procedure, but none of them compare the recovery time of both agent. This study aims to compare the recovery time of fentanyl and remifentanyl in pediatric patients undergoing methoterexate therapy. Subjects and Method: This was a double-blind randomized controlled trial on 36 patients who underwent intratechal methotrexate chemoterapy under general anesthesia anesthesia in pediatric intervention room of Moewardi General Hospital Surakarta that met inclusion criteria. The dependent variable was recovery time and the independent variable were fentanyl and remifentanyl. The samples were divided into 2, Fentanyl (F) and Remifentanyl (R) group. Recovery time was recorded after the procedure until the subject reached Pediatric Glasgow Comma Scale (PGCS) of 15. Statistical analysis was Mann Whitney U Test using SPSS 25 for Windows. Results: The mean recovery time of F group was 373.39 ± 29.48 seconds, while R group was 124.67±11.55 seconds. There was a significant difference in recovery time between patients in the Fentanyl group and the Remifentanyl group (p= 0.000). Conclusion: Remifentanyl recovery time was significantly faster than with fentanyl in pediatric patients undergoing intrathecal methotrexate chemotherapy.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Comparison of The Effectiveness of Remifentanyl versus Fentanyl in Pediatric Undergoing Methotrexate Therapy

Purwoko¹,

Putro²,

Pamungkas³

et al. 2022

INDONES J MED

View full text Add to dashboard Cite

show abstract

“…A randomized study compared the combination of propofol + remifentanil ( n = 10) vs. midazolam + remifentanil ( n = 10) with good analgesic efficacy, good intubation conditions and good tolerance ( 59 ). Three observational studies were performed with remifentanil ( 60 – 62 ) and two of them ( 61 , 62 ) reported concerning chest rigidities, responsible for the premature interruption of one of these studies ( 61 ).…”

Section: Actionable Recommendationsmentioning

confidence: 99%

Premedication before laryngoscopy in neonates: Evidence-based statement from the French society of neonatology (SFN)

Durrmeyer

Walter-Nicolet²,

Chollat³

et al. 2023

Front. Pediatr.

Self Cite

View full text Add to dashboard Cite

ContextLaryngoscopy is frequently required in neonatal intensive care. Awake laryngoscopy has deleterious effects but practice remains heterogeneous regarding premedication use. The goal of this statement was to provide evidence-based good practice guidance for clinicians regarding premedication before tracheal intubation, less invasive surfactant administration (LISA) and laryngeal mask insertion in neonates.MethodsA group of experts brought together by the French Society of Neonatology (SFN) addressed 4 fields related to premedication before upper airway access in neonates: (1) tracheal intubation; (2) less invasive surfactant administration; (3) laryngeal mask insertion; (4) use of atropine for the 3 previous procedures. Evidence was gathered and assessed on predefined questions related to these fields. Consensual statements were issued using the GRADE methodology.ResultsAmong the 15 formalized good practice statements, 2 were strong recommendations to do (Grade 1+) or not to do (Grade 1−), and 4 were discretionary recommendations to do (Grade 2+). For 9 good practice statements, the GRADE method could not be applied, resulting in an expert opinion. For tracheal intubation premedication was considered mandatory except for life-threatening situations (Grade 1+). Recommended premedications were a combination of opioid + muscle blocker (Grade 2+) or propofol in the absence of hemodynamic compromise or hypotension (Grade 2+) while the use of a sole opioid was discouraged (Grade 1−). Statements regarding other molecules before tracheal intubation were expert opinions. For LISA premedication was recommended (Grade 2+) with the use of propofol (Grade 2+). Statements regarding other molecules before LISA were expert opinions. For laryngeal mask insertion and atropine use, no specific data was found and expert opinions were provided.ConclusionThis statement should help clinical decision regarding premedication before neonatal upper airway access and favor standardization of practices.

show abstract

“…The American Academy of Pediatrics recommended premedication, including analgesics, atropine, and muscle relaxants, for neonates subjected to elective tracheal intubation (30). Despite the existing recommendations, previous studies reported that the frequency of premedication prior to elective intubation ranges widely (26,(30)(31)(32)(33). An online survey among neonatologists concerning premedication for elective tracheal intubation showed that 72% of the respondents considered premedication as obligatory, while only 34% of them used it frequently (33).…”

Section: Management Of Acute Procedural Painmentioning

confidence: 99%

Changes in Physicians' Perceptions and Practices on Neonatal Pain Management Over the Past 20 Years. A Survey Conducted at Two Time-Points

et al. 2021

View full text Add to dashboard Cite

Intense research for more than three decades expelled the view that neonates do not experience pain. The aim of this survey was to investigate whether the Greek physicians involved in neonatal intensive care have changed their perceptions regarding neonatal pain, adapting their management practices to the knowledge that have emerged in the past 20-years. This study is a survey conducted at two time-points, 20 years apart. Anonymous questionnaires were distributed to 117 and 145 physicians working in neonatal intensive care units (NICUs) all over Greece in years 2000 and 2019, respectively. The response rate was 90.6 and 80.7% in 2000 and 2019, respectively. All respondents, at both time-points, believed that neonates experience pain, which has serious acute and long-term consequences, while the vast majority considered analgesia-sedation (A-S) during painful interventions as obligatory. Utilization of NICU protocols and pain assessment tools remained low although increased significantly between 2000 and 2019. The use of systemic A-S postoperatively was high at both time-points, while its implementation in infants subjected to prolonged pain, specifically mechanical ventilation, increased significantly by 2019. Systemic or local analgesia for acute procedural pain was used by lower proportions of physicians in 2019, except for the tracheal intubation. In contrast, the use of sweet solutions and non-pharmacological measures prior to or during bedside procedures significantly increased over time. Opioid administration significantly increased, while a shift from morphine to fentanyl was observed. International literature and perinatal–neonatal congresses were stated as the main sources of updating physicians' knowledge and improving management practice on neonatal pain prevention and treatment. In conclusion, Greek NICU-physicians' perceptions that neonates can experience pain with potentially serious acute and long-term consequences remained strong over the past 20 years. Although physicians' practices on neonatal pain management improved, they are still suboptimal, while significant differences exist among centers. Continuing education, globally accepted management protocols, and readily applied pain assessment tools would further improve the management of procedural pain and stress in neonates.

show abstract

Efficacy and Safety Aspects of Remifentanil Sedation for Intubation in Neonates: A Retrospective Study

Cited by 7 publications

References 26 publications

Comparison of The Effectiveness of Remifentanyl versus Fentanyl in Pediatric Undergoing Methotrexate Therapy

Comparison of The Effectiveness of Remifentanyl versus Fentanyl in Pediatric Undergoing Methotrexate Therapy

Premedication before laryngoscopy in neonates: Evidence-based statement from the French society of neonatology (SFN)

Changes in Physicians' Perceptions and Practices on Neonatal Pain Management Over the Past 20 Years. A Survey Conducted at Two Time-Points

Contact Info

Product

Resources

About