----- Original Message -----
From: Gautam
> I prefer to spare as much opiate as
> possible by using a cocktail of entonox, ketorolac and just a sniff of
> midazolam. Once XRayed, top up the midazolam, turn up the nitrous oxide
> and reduce.
Yes Goat, I forgot to mention entonox. Right now I'm just back from my
graveyard shift - the latter refers to the ungodly hour, not to the clinical
outcomes I hasten to add - and I've just done two shoulder reductions purely
under entonox. Using the Boyle's machine I crank up 2 lpm oxygen and 6 lpm
nitrous oxide to produce a 75% nitrous mixture. It produces a dissociated
state within minutes, and is perfectly adequate for an (accelerated)
Kocher's technique. Very rapid recovery and no (electronic) monitoring is
required or i.v. access. On each case the patient was mobile, not just
awake, but walking out of the treatment room within 5 minutes of the start
of the procedure! (There was no time or space to do all the morph and midaz
palaver so this technique worked nicely.)
It's been such a crap night otherwise, I just felt I had to tell you that!
Adrian Fogarty
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