PHYSIOLOGICAL-CHANGES, PLASMA BETA-ENDORPHIN AND CORTISOL RESPONSES TO TRACHEAL INTUBATION IN NEONATES

Physiological, plasma beta-endorphin and cortisol responses to nasotra cheal intubation were studied in 20 distressed infants of median age 0 .3 days (range 0.1-23 days) randomized into groups given pethidine 1 m g/kg (n=10) or alfentanil 20 mu g/kg plus suxamethonium 1.5 mg/kg (n=1 0) before intubation. AII of the infants were given glycopyrrolate 3-5 mu g/kg. Hypoxaemia during intubation was found in all 10 infants in the pethidine group and in 7 of 10 infants in the alfentanil-suxametho nium group, its duration being significantly longer in the pethidine g roup and being associated with the duration of the intubation procedur e. Blood pressure increased, but not statistically significantly, in a ll except 2 patients in the alfentanil-suxamethonium group and bradyca rdia appeared in 1 patient in each group. Plasma beta-endorphin and co rtisol values did not show any statistically significant intra-group o r inter-group differences. Newborn infants suffer from hypoxaemia duri ng intubation when awake more and therefore need adequate premedicatio n before elective intubation. One alternative is the combination of gl ycopyrrolate, alfentanil and suxamethonium described here, although th e ideal medication and dosage still remain to be defined.