In Reply.—

We are extremely grateful for the comments by Papoff et al concerning our report on the propofol regimen, compared with the morphine, atropine, and suxamethonium regimens, as induction for neonatal endotracheal intubation. We are equally interested in the findings of their pilot trial, which are encouraging.

Propofol, a general anesthetic agent, serves as a deep sedative and is amnestic at optimal dose. At hypnotic doses, propofol causes slowing of brain activity shown with electroencephalography. We indeed had considered, but eventually decided against, the use of a narcotic in combination with propofol in our randomized trial, because one of our goals was to search for a single premedicating agent that would ease clinical practice. Furthermore, concurrent administration of analgesics with propofol has been shown to increase the likelihood of adverse outcomes, and there is evidence from pediatric and adult literature that propofol offers good sedation...

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