Table 2.

Summary of good practice statements for premedication prior to neonatal laryngoscopy for tracheal intubation or LISA.

Question	Statement	Overall LoE	Strength of recommendation
Endotracheal intubation
Should premedication be performed in neonates prior to tracheal intubation compared to awake intubation outside life-threatening emergencies?	Premedication must be performed in neonates prior to tracheal intubation outside life-threatening emergencies	B	1+
Can the combination of an opioid with a muscle blocker be used as premedication prior to tracheal intubation in neonates?	The combination of an opioid with a muscle blocker should probably be considered as possible premedication prior to tracheal intubation in neonates. Caveat: the use of muscle blocker eliminates all spontaneous ventilation and requires effective mask ventilation.	B	2+
Can a sole opioid be used as premedication prior to tracheal intubation in neonates?	Morphine or intravenous (IV) remifentanil alone must not be considered as premedication prior to tracheal intubation in neonates.	B	1−
Can IV midazolam alone be used as premedication prior to tracheal intubation in neonates?	The experts suggest avoiding the use of IV midazolam alone prior to tracheal intubation in neonates. The experts suggest that IV midazolam in combination with a rapid-acting synthetic opioid should be considered as a possible premedication prior to tracheal intubation in neonates.	C	Expert opinion
Can IV propofol be used as premedication prior to tracheal intubation in neonates?	IV propofol should probably be considered as a possible premedication prior to tracheal intubation in neonates.	B	2+
Can IV ketamine be used as premedication prior to tracheal intubation in neonates?	The experts suggest to consider IV ketamine as a possible premedication prior to tracheal intubation in neonates.	D	Expert opinion
If there is no venous access, can intranasal midazolam or ketamine be used as premedication in neonates prior to tracheal intubation?	The experts recommend that every effort should be made to establish a venous access prior to tracheal intubation in neonates. In the absence of a venous access, the experts suggest considering the intranasal administration of ketamine or midazolam as possible premedications, without it being possible to establish a preference between these 2 molecules.	C	Expert opinion
Premedication before less-invasive surfactant administration (LISA)
Should neonates receive premedication prior to LISA?	Premedication should probably be administered prior to LISA.	B	2+
Can IV opioids be used as a premedication prior to LISA in neonates?	The experts suggest to consider IV fentanyl as a possible premedication prior to LISA in neonates.	C	Expert opinion
Can IV propofol be used as a premedication prior to LISA in neonates?	IV propofol should probably be considered as a possible premedication prior to LISA in neonates.	B	2+
Can IV ketamine be used as a premedication prior to LISA in neonates?	The experts suggest to consider IV ketamine as a possible premedication prior to LISA in neonates.	D	Expert opinion

LISA, less invasive surfactant administration; LoE, level of evidence.