Sunday, April 2, 2017

Any Other Anesthesia People?

I got a comment from an anesthesia person on this post: No Midazolam: Heart Cath and Amnesia


The current recommendation in the anesthesia community is avoiding benzos in patients over the age of 65-70. I personally don't give them at all unless a patient is so nervous they are crying and shaking, and even then I will try something else first. Cardiologists, gastroenterologists, etc. don't have the luxury of administering propofol because of safety and liability issues, so they use benzos and narcotics for sedation.

I am encouraged by this person's comment.  I hope that the age of the patient is lowered until the drug, Versed, isn't used. I do understand the problem with using Propofol in a setting without properly trained and extremely vigilant medical personnel who are properly equipped for emergencies. However, the medical field has ignored the problems with Versed because they are telling us and themselves that Versed is "just like Valium."  It isn't.  Valium is Valium and Versed is Versed.  The chemical construction is different, the amount of drug that is fatal is different, and the effects are different.  

I have found that Fentanyl as sole agent, isn't only a painkiller many times more effective than Morphine, it is also a sedative.  The real kind which ameliorates pain, and as a side effect calms the patient.  Not everybody likes Fentanyl, but for me, this is what I want.  I agree with the anesthetists assessment, with the exception of the age.  I think the cutoff age should be much lower.

Thanks to the commenter for leaving us this wisdom.  

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