M Bissuel1, C Deguines, P Tourneux. 1. Service de médecine néonatale et réanimation pédiatrique polyvalente, CHU d'Amiens, 80054 Amiens cedex 1, France.
Abstract
BACKGROUND: Various analgesics and sedatives are currently available for critically ill newborns requiring tracheal intubation in the delivery room. Even if pain management has improved over the past few years, there are few recent data on the French clinical practices in the delivery room. OBJECTIVES: To describe the use of sedatives and/or analgesics before tracheal intubation in the delivery rooms of French type III maternity units. METHODS: A phone interview was conducted in 63 maternity units between April and August 2011. RESULTS: Sixty-two maternity units (98%) completed the interview. Twenty-nine percent of the preterm newborns requiring intubation for elective surfactant therapy and 77.4% requiring intubation for prophylactic surfactant therapy did not receive any sedative and/or analgesic treatment. Written guidelines were present in 58.1% of the units. The most frequent sedative and/or analgesic treatments were sufentanil, ketamine, midazolam, and propofol. The first vascular access was a central umbilical catheter or a peripheral venous catheter for most of the centers. CONCLUSION: The use of sedation-analgesia is still insufficient in French maternity units. Tracheal intubation without the use of analgesia and sedation should be performed only for life-threatening situations in the delivery room.
BACKGROUND: Various analgesics and sedatives are currently available for critically ill newborns requiring tracheal intubation in the delivery room. Even if pain management has improved over the past few years, there are few recent data on the French clinical practices in the delivery room. OBJECTIVES: To describe the use of sedatives and/or analgesics before tracheal intubation in the delivery rooms of French type III maternity units. METHODS: A phone interview was conducted in 63 maternity units between April and August 2011. RESULTS: Sixty-two maternity units (98%) completed the interview. Twenty-nine percent of the preterm newborns requiring intubation for elective surfactant therapy and 77.4% requiring intubation for prophylactic surfactant therapy did not receive any sedative and/or analgesic treatment. Written guidelines were present in 58.1% of the units. The most frequent sedative and/or analgesic treatments were sufentanil, ketamine, midazolam, and propofol. The first vascular access was a central umbilical catheter or a peripheral venous catheter for most of the centers. CONCLUSION: The use of sedation-analgesia is still insufficient in French maternity units. Tracheal intubation without the use of analgesia and sedation should be performed only for life-threatening situations in the delivery room.