Effect of Atropine With Propofol vs Atropine With Atracurium and Sufentanil on Oxygen Desaturation in Neonates Requiring Nonemergency Intubation

A Randomized Clinical Trial

Durrmeyer, et al (the PRETTINEO Research Group) JAMA. 2018

Question  Does premedication with propofol reduce the frequency of prolonged desaturation during nasotracheal intubation in neonates compared with the combination of a rapid-onset short-acting opioid and a muscle relaxant?

Findings  In this randomized clinical trial involving 173 neonates undergoing nonemergency nasotracheal intubation, the frequency of a pulse oximetry value less than 80% for at least 60 consecutive seconds for atropine with propofol was 60% vs 66% for atropine with atracurium and sufentanil. Although this difference was not statistically significant, the confidence interval included a clinically important difference.

Meaning  Although this study did not find a statistically significant difference between interventions, it may have been underpowered, and further research may be warranted.

Conclusions and Relevance  Among neonates undergoing nonemergency nasotracheal intubation, the frequency of prolonged desaturation did not differ significantly between atropine used with propofol or atropine used with atracurium and sufentanil. However, the study may have been underpowered to detect a clinically important difference, and further research may be warranted.