ArticleBrazilian journal of anesthesiology (Elsevier)2026
Remifentanil for modified rapid sequence induction in children: a proof-of-concept study in a selected pediatric population.
Article in Brazilian journal of anesthesiology (Elsevier), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionRapid Sequence Induction (RSI) is widely used in pediatric anesthesia for children at risk of pulmonary aspiration. Modified RSI has been proposed to reduce the risk of hypoxemia during induction while maintaining airway protection. This proof-of-concept study aimed to describe peri-intubation outcomes associated with the use of intravenous bolus remifentanil during modified RSI in a selected pediatric population at risk of pulmonary aspiration.
methodsThis proof-of-concept study analyzed data from pediatric patients, with at least one risk factor for pulmonary aspiration, undergoing modified RSI with remifentanil between December 2021 and August 2023. Exclusion criteria included the planned use of a neuromuscular blocking agent for RSI, preoperative hypoxemia, hemodynamic shock or difficult intubation risk factors. Remifentanil was administered by direct intravenous injection with optional prophylactic administration of atropine. Data on intubation success rates, major and minor complications and rescue treatment were collected and analyzed.
resultsA total of 267 children were included (median age 8.0 years [IQR 5.0-12.0]). Successful first-attempt intubation without major complications was achieved in 92.9% (248/267; 95% CI 88.9-95.6). No major complications were reported. Nineteen patients (7.1%) required more than one intubation attempt. In multivariable analysis, age < 1-year (adjusted OR = 11.4, 95% CI 3.5-34.3; p < 0.001) and Cormack-Lehane grade ≥ 2 (adjusted OR = 10.2, 95% CI 1.8-57.2; p = 0.008) were associated with failed first-attempt intubation. Minor complications occurred in 15.7% of patients, mainly transient hypotension.
conclusionIn this proof-of-concept study of a selected pediatric population, modified RSI with remifentanil was associated with a first-attempt intubation success rate of 92.9%, with no major complications observed. These descriptive findings should be considered hypothesis-generating and support further evaluation of remifentanil-based modified RSI in prospective randomized studies.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.