Whyte S, Birrell G, Wyllie J
Department of Anaesthetics, Liverpool Women's Hospital, Liverpool L8 7SS.
Arch Dis Child Fetal Neonatal Ed. 2000 Jan;82(1):F38-41. doi: 10.1136/fn.82.1.f38.
To establish the extent and type of premedication used before intubation in neonatal units in the United Kingdom.
A structured telephone survey was conducted of 241 eligible units. Units were subdivided into those that routinely intubated and ventilated babies (routine group) and those that transferred intubated and ventilated babies (transfer group).
Of the units contacted, 239 (99%) participated. Only 88/239 (37%) gave any sedation before intubating on the unit and only 34/239 (14%) had a written policy covering this. Morphine was used most commonly (66%), with other opioids and benzodiazepines used less frequently. Of the 88 units using sedation, 19 (22%) also used paralysis. Suxamethonium was given by 10/19 (53%) but only half of these combined it with atropine. Drug doses varied by factors of up to 200, even for commonly used drugs.
Most UK neonatal units do not sedate babies before intubating, despite evidence of physiological and practical benefits. Only a minority have written guidelines, which prohibits auditing of practice.
确定英国新生儿重症监护病房在插管前使用的术前用药的范围和类型。
对241个符合条件的病房进行了结构化电话调查。这些病房被分为常规对婴儿进行插管和通气的病房（常规组）以及接收已插管和通气婴儿的病房（转运组）。
在被联系的病房中，239个（99%）参与了调查。只有88/239（37%）的病房在病房内插管前给予了镇静，只有34/239（14%）有关于此的书面政策。吗啡使用最为普遍（66%），其他阿片类药物和苯二氮䓬类药物使用较少。在88个使用镇静的病房中，19个（22%）也使用了肌松药。10/19（53%）的病房使用了琥珀胆碱，但其中只有一半将其与阿托品联合使用。即使是常用药物，药物剂量也相差高达200倍。
尽管有生理和实际益处的证据，但大多数英国新生儿重症监护病房在插管前不给予婴儿镇静。只有少数有书面指南，这使得对实践的审核受到限制。
