Comparison of the Effect of Remifentanil Plus Atropine with Fentanyl and Remifentanil Alone on Preterm Infants’ Vital Signs in Non-emergency Intratracheal Intubation

Document Type : Original Article


1 Department of Pediatrics, Faculty of Medicine, University of Medical Sciences, Tabriz, Iran

2 Research Center for Evidence Based Medicine (RCEBM), Tabriz University of Medical Sciences, Tabriz, Iran.

3 Clinical Research Development Unit of Children Hospital, University of Medical Sciences, Tabriz, Iran.


Background: Intratracheal intubation is associated with many side effects. Different groups of drugs have been used to control these side effects, but there is still no consensus on the most suitable drugs.
This study aimed to compare the effect and possible side effects of fentanyl, remifentanil, and atropine plus remifentanil on the vital signs of preterm infants in non-emergency intratracheal intubation.
Methods: In this randomized clinical trial study, 75 neonates with a gestational age of 27 to 34 weeks who required temporary intubation were included in the study and divided into three groups by computer randomization. Then, the effects and possible side effects of remifentanil, fentanyl, and remifentanil with atropine on clinical parameters (blood pressure, heart rate, and arterial oxygen saturation) were investigated.
Results: A total of 75 neonates with a mean gestational age of 30.4 weeks were studied. There was no significant difference between study groups in terms of changes in the systemic blood pressure and heart rate, but the mean oxygen saturation in all three groups was significantly different at different measurement times (P-value: 0.036). The group receiving remifentanil plus atropine reported minimal changes in oxygen saturation and their oxygen saturation was significantly higher than the other groups 30 min after extubation.
Conclusion: The use of remifentanil with atropine in preterm infants is associated with lower changes in oxygen saturation and higher arterial oxygen saturation 30 min after extubation. The use of remifentanil or remifentanil with atropine or fentanyl has no significant effect on the blood pressure and heart rate of neonates in non-emergency intratracheal intubation.


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