Premedication for preventing pain in infants undergoing non‐urgent breathing tube placement

ISRCTN ISRCTN13875422
DOI https://doi.org/10.1186/ISRCTN13875422
ClinicalTrials.gov (NCT) Nil known
Clinical Trials Information System (CTIS) Nil known
Protocol serial number Nil known
Sponsor Children’s Hospital of Nanjing Medical University
Funders Project of Futang Children's Science Foundation (FTCSF-2018-04), Nanjing Special Fund for Health Science and Technology Development (grant no. 201723007)
Submission date
10/09/2022
Registration date
12/10/2022
Last edited
12/10/2022
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Respiratory
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data
Record updated in last year

Plain English summary of protocol

Background and study aims
Endotracheal intubation is a medical procedure in which a tube is placed into the windpipe through the mouth or nose. It may cause discomfort and pain, as well as harmful physiological reactions. Analgesics have been found to relieve pain caused by endotracheal intubation. The aim of this study is to evaluate the analgesic effect of combined administration before non-emergency endotracheal intubation in infants.

Who can participate?
Infants in the neonatal intensive care unit at Children’s Hospital of Nanjing Medical University who require endotracheal intubation

What does the study involve?
Infants are randomly assigned to experimental and control groups. The experimental group are injected with 5% glucose 2 ml + atropine 0.02 mg/kg (1 min) and 5% glucose 2 ml and fentanyl 2 ug/kg (5 min) before endotracheal intubation. The control group are injected with 5% glucose 2 ml (1 min) and 5% glucose 2 ml (5 min) before endotracheal intubation. The degree of pain during the examination is recorded.

What are the possible benefits and risks of participating?
There are no direct benefits or risks involved in taking part in this study.

Where is the study run from?
Children’s Hospital of Nanjing Medical University (China)

When is the study starting and how long is it expected to run for?
March 2017 to March 2022

Who is funding the study?
Children’s Hospital of Nanjing Medical University (China)

Who is the main contact?
Dr Keyu Lu, lukeyu19892001@sina.com

Contact information

Dr Keyu Lu
Principal investigator

Guangzhou Road 72
Nanjing
210009
China

Phone +86 (0)8613951703146
Email lukeyu19892001@sina.com

Study information

Primary study designInterventional
Study designMulticenter interventional double-blinded randomized controlled trial
Secondary study designRandomised controlled trial
Study type Participant information sheet
Scientific titleEffectiveness of fentanyl and atropine for premedication of the newborn infant before non-emergency endotracheal intubation: a randomized controlled trial
Study acronymPBNEEI
Study objectivesFentanyl and atropine might decrease the pain response during non‐urgent endotracheal intubation in neonates
Ethics approval(s)Approved 25/05/2017, Children’s Hospital of Nanjing Medical University Ethics Committee (72 Guangzhou Road, Nanjing, China; +86 (0)83117281; nanjingnicu@163.com), ref: #201703069
Health condition(s) or problem(s) studiedPremedication for non‐urgent endotracheal intubation for preventing pain in neonates with respiratory failure
InterventionThe research team comprised three research neonatologists, a child health care expert, and three assistants with extensive research and clinical experience. Following the acquisition of informed consent from the guardians, the infants were randomly assigned to either the experimental group or the control group using a computer-generated randomization code. Subjects and intubators are blinded.

The experimental group are intravenously injected with 5% glucose 2 ml + atropine 0.02 mg/kg (1 min) and 5% glucose 2 ml + fentanyl 2 ug/kg (5 min) successively before endotracheal intubation. The control group are intravenously injected with 5% glucose 2 ml (1 min) and 5% glucose 2 ml (5 min) successively before endotracheal intubation.
Intervention typeDrug
PhasePhase IV
Drug / device / biological / vaccine name(s)Fentanyl, atropine
Primary outcome measure(s)

1. Behavioural responses measured using the N-PASS score at the time of intubation
2. Analgesic efficacy measured using plasma neuron-specific enolase (NSE), cortisol and endorphins concentrations in venous blood samples before and after intubation

Key secondary outcome measure(s)

1. Conditions of endotracheal intubation (difficulty of intubation, the opening and closing state of the glottis, and the children's response to intubation) evaluated using the modified Goldberg score at the time of intubation
2. Adverse reactions evaluated using heart rate (HR), oxygen saturation (SaO₂) and regional cerebral oxygen saturation (rScO₂) before and after intubation

Completion date01/03/2022

Eligibility

Participant type(s)Patient
Age groupNeonate
SexAll
Target sample size at registration80
Total final enrolment80
Key inclusion criteriaChildren with indications for endotracheal intubation, intravenous access or time to open intravenous access, and able to complete intubation within 15-30 minutes
Key exclusion criteria1. Children with emergency intubation
2. Structural abnormalities of the upper respiratory tract (e.g. Pierre-Robin syndrome, glottic stenosis)
3. Upper digestive tract malformation (such as diaphragmatic hernia)
4. A history of difficulty in endotracheal intubation
5. Central respiratory failure caused by asphyxia or brain injury
6. Children intubated twice or more during treatment
Date of first enrolment30/06/2017
Date of final enrolment30/06/2020

Locations

Countries of recruitment

  • China

Study participating centres

Children’s Hospital of Nanjing Medical University
Guangzhou Road 72
Nanjing
210009
China
Children’s Hospital of Harbin Medical University
No. 57, you yi Road
Dao li District
Harbin
150010
China

Results and Publications

Individual participant data (IPD) Intention to shareNo
IPD sharing plan summaryData sharing statement to be made available at a later date
IPD sharing planThe data sharing plans for the current study are unknown and will be made available at a later date.

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Participant information sheet Participant information sheet 11/11/2025 11/11/2025 No Yes

Editorial Notes

10/10/2022: Trial's existence confirmed by the Children’s Hospital of Nanjing Medical University Ethics Committee.