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Updated: Jun 12, 2026
11:19
Guidelines for Elective Pediatric Fiberoptic Intubation
Published on: January 17, 2011
Rocuronium for nonemergent intubation of term and preterm infants
D M Feltman1, M G Weiss, P Nicoski
1Division of Neonatology, Department of Pediatrics, Loyola University Medical Center, Maywood, IL, USA. DFeltman@northshore.org
Summary
Rocuronium significantly improved first-attempt intubation success in infants. This neuromuscular blocker provided rapid clinical paralysis, aiding nonemergent intubations in preterm infants.
Area of Science:
- Pediatric Anesthesiology
- Neonatal Critical Care
- Pharmacology
Background:
- Nonemergent intubation in infants presents unique challenges.
- Optimizing intubation success and safety is crucial for neonatal outcomes.
Purpose of the Study:
- To evaluate rocuronium's clinical characteristics as a premedication for nonemergent infant intubation.
- To assess the impact of rocuronium on intubation success rates and clinical paralysis.
Main Methods:
- A randomized trial involving preterm infants undergoing nonemergent intubation.
- Infants received atropine and fentanyl with or without rocuronium.
- Clinical paralysis onset, duration, and intubation success were recorded.
Main Results:
- Rocuronium use was associated with a significantly higher first-attempt intubation success rate (35% vs. 8%).
- Complete clinical paralysis was achieved in 80% of infants receiving rocuronium.
- The onset of paralysis ranged from 14 to 178 seconds, with a mean duration of 16.3 minutes.
Conclusions:
- Rocuronium effectively facilitates successful intubation in infants.
- Rocuronium provides rapid clinical paralysis, enhancing the intubation procedure.
- This study supports the use of rocuronium as a premedication in specific infant intubation scenarios.
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