Premedication for laryngoscopy in the newborn infant

Laryngoscopy is commonly performed in the neonatal intensive care unit and is known to be associated with adverse effects. The use of premedication has been shown to decrease these effects and increase success rates. In all nonemergent intubations, premedication with a vagolytic, fast-acting opiate, and short-acting muscle relaxant should be provided. For less invasive surfactant administration, nonpharmacological measures should always be prioritized. Fast-acting opiate agents are also recommended combined with a vagolytic agent. Laryngoscopy should always be performed or supervised by a skilled provider, with constant cardiorespiratory monitoring in place.