Neonatal preintubation sedation: a national survey in Malaysia

Amar–Singh HSS, Sharon Linus-Lojikip, Zarena Ismail, Nurul-Huda Ishahar, Siti-Suhaila Yusof

There is a shift of practice towards administering sedation in neonates around the world. At the present moment, there is no available data or literature on the practice of sedation before intubation of neonates in Malaysia thus, evaluation of these practice was not possible. This study was conducted to evaluate neonatal preintubation sedation practice and the availability of neonatal preintubation sedation policy in government, university and private Malaysian Neonatal Intensive Care Units (NICUs) in 2007. All 43 NICUs in Malaysia were identified and approached to participate in the study. Phone interviews with doctors' in-charge of NICUs were conducted in 29 governments, 3 universities and in 7 private NICUs. Only 7 NICUs had written policy on neonatal preintubation sedation use. Seventy-seven percent and 97.4 % of NICUs used sedation during emergency intubation and during planned intubation respectively. Sixty seven percent used either morphine or midazolam with no preference of either drug. This study showed a significant proportion of NICUs used sedation during emergency or planned intubation. However, the majority does not write policy on neonatal preintubation sedation use (82.1 %). The types and drug administration methods are not standardized in all of the NICUs. This will require a standard national written policy to be developed.