Ellen de Kort

48 Chapter 3 Our study has several limitations, including the small number of patients, no control group treated with another sedative such as propofol, no blinding of doses and no pharmacokinetic analyses of remifentanil. However, our results are an important illustration of daily neonatal care. The combination of opioids with a hypnotic or sedative agent might be more appropriate than the use of a single agent. A slower infusion of remifentanil combined with a low dose of propofol might by an interesting combination to investigate in future studies. CONCLUSIONS We conclude that remifentanil boluses administered in 30 s carry an unacceptably high risk of chest wall rigidity in preterm neonates. Lower doses also provide insufficient sedation.