I'm not aware of any protocol for the use of intranasal fentenyl with
midazolam. We discontinued the use of intranasal midazolam (0.5 mg/kg) as a
third of children complained of the burning sensation when it was given
intranasally and it wasn't as effective as low dose i.m. ketamine.
I'm quite keen on intranasal diamorphine and it is a great improvement on
oral morphine which was usually given when iv access wasn't easy.
Having completed two studies comparing ketamine with high dose midazolam
i.n. 0.5 mg/kg and i.m. 0.4 mg/kg we found that ketamine 2.5 mg/kg with
atropine was much better. All patients also had local anaesthetic prior to
suturing. I think ketamine is the gold standard at the moment although it
may well be worth comparing it with a fentenyl/midazolam intranasal dose.
How about some keen registrars doing some original research? Like us old
folks had to do?
Ray McGlone
A&E Consultant
Lancaster
----- Original Message -----
From: Craig Ellis <[log in to unmask]>
To: <[log in to unmask]>
Sent: Tuesday, January 02, 2001 3:31 PM
Subject: Intranasal fentanyl and midazolam sedation
Does anyone have a protocol for intranasal fentanyl and midazolam in the
sedation of children ?
thanks
Craig
Dr Craig Ellis
Emergency Medicine Registrar
Wellington Hospital
Wellington, New Zealand
CCH Secure Mail Server
****************************************************************************
****
This email or attachment(s) may contain confidential or legally privileged
information intended for the sole use of the addressee(s). Any use,
redistribution, disclosure, or reproduction of this message, except as
intended, is prohibited. If you received this email in error, please notify
the sender and remove all copies of the message, including any attachments.
Any views or opinions expressed in this email (unless otherwise stated) may
not represent those of Capital Coast Health Ltd. (AC_S001)
[INFO] -- Virus Manager:
No Viruses were detected in this message.
****************************************************************************
****
|