Propofol for sedation during less invasive surfactant administration in preterm infants

Sedation during minimal invasive surfactant therapy: a randomised controlled trial

“…However, we report a significantly higher incidence of need for nIMV in the sedation group (93%). This is due to a higher incidence of desaturation, which was comparable to the study of Descamps et al 41. However, the incidence of need for intubation during or within 24 hours after the procedure did not differ between the randomisation groups, thereby indicating that the need for nIMV was transient.…”

Propofol versus placebo (with rescue with ketamine) before less invasive surfactant administration: study protocol for a multicenter, double-blind, placebo controlled trial (PROLISA)

“…In the study by Heiring et al, of 73 North European NICUs performing the LISA procedure 78% declared using medication with a large variety of drugs [30]. Currently the most studied drug is propofol [11,12,20] with promising preliminary results from a single center, unmasked, randomized controlled trial versus no premedication [20]. Moreover, we did not choose fentanyl as a rescue treatment due to the major risk of chest wall rigidity and thus intubation [14,43].…”

“…European guidelines from 2019 state that "LISA [less invasive surfactant administration] is the preferred mode of surfactant administration for spontaneously breathing babies on continuous positive airway pressure (CPAP), provided that clinicians are experienced with this technique" [5]. In the LISA procedure, the operator inserts a thin tube to administer intra-tracheal surfactant to spontaneously breathing preterm infants receiving non-invasive ventilation [6][7][8][9][10][11][12][13][14][15]. After surfactant administration, the catheter is immediately removed and non-invasive ventilation is continued [6].…”

Administering atropine and ketamine before less invasive surfactant administration resulted in low pain scores in a prospective study of premature neonates

“…In the sedated group, the overall intubation rate during the procedure, and within the 24 hour that followed, was 8/23 (35%), which was close to our results with ketamine of 12/29 (41%) when we included immediate and delayed intubations. In a preliminary report on a study that also used propofol (13), the intubation rate in the hour following the procedure was 5/35 (14%), but the overall intubation rate including those intubated for a second surfactant dose was 12/35 (34%). Whether infants should be intubated for a second surfactant administration is unclear, and some of these intubations could be avoided by repeating the LISA procedure.…”