Detection of stress in newborns during intubation by means of skin conductance measurements.

Internationally there is widespread variation in premedication before
intubation of newborns, term and preterm. In the Isala Clinics Zwolle, The
Netherlands we use morphine and vecuronium.
There are reasons to look for an alternative for morphine and vecuronium. The
pharmacokinetic profile of morphine is unfavourable making it relatively
unsuitable for acute interventions. Neuromuscular blockade with vecuronium does
improve intubating conditions. However, the effect lasts relatively long,
resulting in unwanted higher ventilating pressures.
Propofol is a relatively new anesthetic compound with rapid onset and short
duration of action. It provides deep hypnosis and possibly has some analgetic
effect. Since the RCT by Ghanta et al. (2007) propofol is increasingly used in
neonatology.
Intubation is known as a painful procedure. Until now we do not have
information about analgesia during intubation, since neuromuscular blockade and
deep sedation prevent clinical assessment of pain. Therefore we want to use
skin conductance measurements to gain insight in subclinical stress responses
during the intubation procedure.
Our hypothesis is that despite premedication the stress response is still
present during the intubation procedure.

Determining the effectiveness of commonly used premedicating agents in reducing
subclinical stress responses in newborns during intubation.

Prospective randomized open observational intervention study.

not applicable

No burdens or risks.