The purpose of this study is to compare heart rate in infants who receive atropine as a part of their medication before intubation to those who do not.

To be able to find out , we need to divided babies into 2 groups;

group 1 : receives atropine + sedation + muscle relaxant group 2 : receives water or saline ( placebo group) + sedation + muscle relaxant

Then we need to compare heart rate during intubation and duration of intubation between the 2 groups.

We hypothesize that premedication for intubation with fentanyl and succinylcholine alone will maintain equal stability of heart rate and oxygen saturation without a prolongation of time to completion of intubation when compared to a protocol using atropine, fentanyl and succinylcholine.

In order to answer this question we plan to undertake a prospective randomized double blinded control trial of use of atropine as an adjunct for elective intubation of infants less than 46 weeks postmenstrual age.

Inclusion Criteria:

• Any infant (preterm and term) up to 46 weeks corrected age requiring (nonemergent) intubation.
• IV access is obtained
• Informed parental consent

Exclusion Criteria:

• Emergent intubation or need for resuscitation
• Congenital cyanotic heart disease
• Obvious airway abnormalities
• History of myopathy or family history of malignant hyperthermia or known history of phosphocholinesterase deficiency