Frequent Hypoxemia and Apnea after Sedation with Midazolam and Fentanyl

Bailey, Peter L.; Pace, Nathan L.; Ashburn, Michael A.; Moll, Johan W. B.; East, Katherine A.; Stanley, Theodore H.

doi:10.1097/00000542-199011000-00005

Cited by 577 publications

(241 citation statements)

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“…Clinicians are familiar with the respiratory depression that these drugs cause. 2 While both of these agents may be reversed with naloxone and flumazenil respectively, desaturation may be profound, and full recovery of a normal respiratory status and oxygen desaturation may not occur in a timely manner. Droperidol and other butyrophenones provide excellent sedation without respiratory depression but are noted for their side effects.…”

Section: Conclusion : La Dexmédétomidine Et Une Faible Dose De Kétamimentioning

confidence: 99%

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La dexmédétomidine et une faible dose de kétamine assurent une sédation adéquate pendant l’intubation fibroscopique vigile

Scher¹,

Gitlin²

2003

Can J Anesth/J Can Anesth

103

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P Pu ur rp po os se e: : We report the use of the alpha 2 agonist, dexmedetomidine, with low-dose ketamine as a safe and effective treatment strategy to provide adequate comfort and sedation for a patient who fulfilled criteria of a difficult airway and required awake fibreoptic intubation (AFOI).C Cl li in ni ic ca al l f fe ea at tu ur re es s: : A 52-yr-old male with prostate cancer presented for radical prostatectomy. He reported several failed intubations with previous surgeries and airway examination was consistent with a difficult intubation. In addition, previous fibreoptic intubations were unsuccessful. The patient reported extreme apprehension concerning his airway management.The goal of medicating patients for AFOI includes providing comfort and sedation without causing a change in ventilatory status. Dexmedetomidine has a high affinity for the alpha 2 receptor and results in sedation without change in ventilatory status. In addition, dexmedetomidine is a potent anti-sialgogue which makes it desirable for cases involved with airway instrumentation. A loading dose of dexmedetomidine followed by a continuous infusion provided comfort and sedation within ten minutes. While bradycardia and hypotension have been reported with dexmedetomidine use, concurrent low-dose ketamine was employed in this case for it's cardiostimulatory properties and no bradycardia and hypotension were noted. The airway was anesthetized with selective nerve blocks and conditions for airway instrumentation were excellent. There was no change in oxygen saturation or ventilatory status during the administration of medications or airway manipulation. The patient was comfortable, sedated and tolerated the procedures well. There was no recall of the procedure.C Co on nc cl lu us si io on n: : Dexmedetomidine and concurrent low-dose ketamine provided sedation and comfort to this patient who required an AFOI. des difficultés d'intubation prévisibles et la nécessité d'une intubation fibroscopique vigile (IFV). Éléments cliniques : Un homme de 52 ans, atteint d'un cancer de la prostate, a été admis pour une prostatectomie radicale. La mention d'intubations impossibles lors d'interventions chirurgicales antérieures concordait avec l'examen des voies aériennes qui laissait prévoir des difficultés d'intubation. Des intubations fibroscopiques précédentes avaient aussi échoué. Le patient s'est dit très inquiet de subir une intubation. La médication qui accompagne l'IFV vise le confort et la sédation sans

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Section: Conclusion : La Dexmédétomidine Et Une Faible Dose De Kétamimentioning

confidence: 99%

“…Dexmedetomidine has a high affinity for the alpha 2 receptor and results in sedation without change in ventilatory status. In addition, dexmedetomidine is a potent anti-sialgogue which makes it desirable for cases involved with airway instrumentation.…”

mentioning

confidence: 99%

La dexmédétomidine et une faible dose de kétamine assurent une sédation adéquate pendant l’intubation fibroscopique vigile

Scher¹,

Gitlin²

2003

Can J Anesth/J Can Anesth

103

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“…Unfortunately, this combination of drugs can cause respiratory depression, placing the patient at risk for hypoxemia. In a study of volunteers, Bailey et al reported that the combination of midazolam and fentanyl increased the frequency of hypoxemia in 11 of 12 subjects and produced apnea in 6 of 12 subjects [1].…”

Section: Introductionmentioning

confidence: 99%

A Comparison of Dexmedetomidine and Midazolam for Sedation in Gynecologic Surgery Under Epidural Anesthesia

Liang

2011

J Curr Surg

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“…Bu ilaçlar kombine olarak kullanıldığında sinerjistik etkiye sahiptirler ve dikkatli bir şekil-de titre edilmelidirler (19). Ek olarak, kaygıdan ve ağrıdan kaynaklanan hasta hareketini ayır-mak önemlidir.…”

Section: İlaç Seçimiunclassified

The role of sedation on cataract surgery

Önder¹,

Tekelioğlu²,

Demırhan³

et al. 2013

Turk J Bioch

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Topikal anestezi, saydam kornea kesisinden yapılan fakoemülsifikasyon katarakt cerrahisi için genellikle yeterli ve etkin oküler anestezi sağlamaktadır. Ancak aşırı endişeli, kaygılı ve kooperasyonu güç olan olgularda intraoperatif problemlerle karşılaşma hiç de azımsanmayacak kadar çok-tur. Bu olgularda uygulanan oral veya intravenöz sedasyon, bu problemleri büyük oranda ortadan kaldırmaktadır. Bu derlemenin amacı, saydam kornea kesisinden yapılan fakoemülsifikasyon katarakt cerrahisinde sedasyonun rolü ve olası sedasyon alternatiflerinin değerlendirilmesidir.Topical anesthesia for clear corneal phacoemulsification cataract surgery usually provides adequate and effective ocular anesthesia. However, the possibility of intraoperative complications is not rare in anxious, distressed and uncooperative patients. In these cases, oral or intravenous sedation largely eliminates these problems. The purpose of this review is to evaluate the role of sedation in cataract surgery and possible sedation alternatives.Anahtar Kelimeler: katarakt cerrahisi, sedasyon.

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Frequent Hypoxemia and Apnea after Sedation with Midazolam and Fentanyl

Cited by 577 publications

References 0 publications

La dexmédétomidine et une faible dose de kétamine assurent une sédation adéquate pendant l’intubation fibroscopique vigile

La dexmédétomidine et une faible dose de kétamine assurent une sédation adéquate pendant l’intubation fibroscopique vigile

A Comparison of Dexmedetomidine and Midazolam for Sedation in Gynecologic Surgery Under Epidural Anesthesia

The role of sedation on cataract surgery

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