Review Article

Sedation of Newborn Infants for the INSURE Procedure, Are We Sure?

Table 2

Summary of used premedication before intubation in publications studying the INSURE procedure.

AuthorPremedication and dosageNumber of patientsPatient characteristicsEffect of premedication
Time to extubationINSURE failureReason for INSURE failure

Ancora et al. 2010 [26] Atropine 20 µg/kg, fentanyl 1–3 µg/kg, naloxone 40 µg/kg optional38GA < 32 weeks and BW < 1500 gramsNot described14 patientsSevere apnea in 13 patients
Van den Berg et.al. 2010 [22]Morphine 100 µg/kg or pethidine 1 mg/kg, nalaxon 10 µg/kg before extubation16GA < 32 weeksNot describedNot describedNot described
Bohlin et al. 2007 [23]Morphine 200 µg/kg and Pentobarbital 2 mg/kg, naloxone 0.1 mg/kg before extubation42GA 27–34 weeksNot described1 patientOverdose of pentobarbital
Cherif et al. 2008 [20]Morphine 200 µg/kg109GA 27–35 weeks6.3 ± 1.7 minutes (range 5–12 minutes)35 patientsNot described
Flor-de-Lima et.al. 2012 [18]Morphine 100 µg/kg, naloxone 100 µg/kg optional15BW < 1500 gramsNot describedNot describedNot described
Gizzi et al. 2012 [25]Fentanyl 0.5–2 µg/kg, naloxone 40 µg/kg optional64GA < 32 weeksNot described13 patientsApnea in 4 patients
Leone et al. 2013 [27]Fentanyl 0.2 mg/kg42GA < 34 weeksNot describedNot describedNot described
Sandri et al. 2004 [24]Fentanyl 0.5–2 µg/kg51GA 28–32 weeksNot describedNot describedNot described
Verder et al. 1994 [19]Morphine 100 ug/kg, atropine 10 ug/kg, naloxon 10 ug/kg optional 35GA 25–35 weeksNot described15 patientsApnea in 10 patients
Verder et al. 1999 [21]Morphine 100 µg/kg optional, naloxon 10 µg/kg before extubation optional60GA < 30 weeksNot described4 patientsApnea in 2 patients
Welzing et al. 2009 [16]Remifentanil 2 µg/kg and atropine 10 µg/kg21GA 29–32 weeksStart CPAP at 10.9 minutes (1–30 minutes) and extubation at 42.4 minutes (1–330 minutes)Not describedNot described
Welzing et al. 2010 [17]Propofol 1 mg/kg and atropine 10 µg/kg13GA 29–32 weeksStart CPAP at 25 minutes (2–120 minutes)1 patientInadequate respiratory drive