----- Original Message -----
From: "Richard BAILEY" <[log in to unmask]>
To: <[log in to unmask]>
Sent: Wednesday, October 02, 2002 7:04 AM
Subject: Re: Bier's Block
> I know some folk get a bit twitchy about using opiates and
> midazolam together but at the end of the day if the worst happens both
> agents are easily reversible and basic airway management should not be
> beyond our wit.
Nothing wrong with "balanced" sedation Bill. The analgesic used will "spare"
the amount of sedation agent required, and overall should lead to fewer
complications. (But try fentanyl alone, it works as sedo-analgesia;
analgesia so profound that the patient also becomes sedated, so midaz is no
longer required.) But as you point out, the important principle is to be
proficient at detecting airway obstruction or apnoea or both, and to know
how to deal with these conditions, which does not necessarily mean reversing
the drugs. We discourage our SHOs from using these techniques.
Adrian Fogarty
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