In the past, infants with RDS were intubated, mechanically ventilated and surfactant was administered via the endotracheal tube. However, research shows mechanical ventilation in neonates increases the risk of bronchopulmonary dysplasia, pneumothorax and intraventricular haemorrhage. Less/minimal Invasive Surfactant Administration (LISA/MIST). The surfactant is delivered to the awake and spontaneously breathing infants on non-invasive respiratory support via a thin catheter passed through the vocal cords and administered slowly over 3-5 minutes. LISA is now the most common way of delivering surfactant in the UK, but the need for sedation/analgesia for LISA is still a subject for debate. Nonetheless, sedation may increase the chance for an uneventful, smooth and successful LISA procedure but may also compromise the infant’s respiratory drive which is a necessity for the procedure. The aim of the article was to analyse the literature and evidence surrounding LISA for the preterm infant with or without sedation. It will take into account the gestational age as one of the main factors in deciding whether to sedate or not.

Robyn Jones qualified as a paediatric nurse in 2009 receiving a diploma of higher education at the university of Surrey. She then started as a staff nurse in NNU at Frimley Park Hospital in September 2009. In 2011 she completed Neonatal Nursing 407 level 7 course at St Georges Hospital University and became a Sister in 2013. From 2018-2020 she completed the advanced neonatal nurse practitioners course at Southampton and completed the MSc in 2023. Currently working at Frimley Park NNU as an advanced neonatal nurse practitioner on the SpR rota.