We report a 44 year-old, American Society of Anesthesiologist Class I (ASA I), female patient scheduled for elective excision of a small lipoma of the left thigh. She went into a 90 minute apnea and complete muscle paralysis as evidenced by the absence of all stimulatory responses by a peripheral nerve stimulator after receiving midazolam (1.0 mg) and fentanyl (100 μg) intravenously for sedation and analgaesia. The patient made an uneventful recovery after 90 minutes. No cause and effect relationship could be established between the administered drugs and this unusual response.
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Front Vet Sci
December 2024
Experimental Surgery Facility, Experimental Animal Center, Faculty of Medicine, University of Bern, Bern, Switzerland.
Introduction: Use of veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is still in the focus of research, in which pigs are commonly involved. During VA-ECMO, cardiovascular parameters are artificially manipulated and therefore not reliable indicators of nociception. Nociceptive withdrawal reflex (NWR) thresholds can be a suitable alternative in such a context.
View Article and Find Full Text PDFGastroenterol Nurs
December 2024
About the authors: Frances R. Roe, MSN, RN, CNOR, Clinical Practice Support, Legacy Health, Portland, Oregon.
Anesthesia shortages impact patient accessibility to endoscopy procedures. The administration of midazolam and fentanyl by a nurse is an accepted practice of delivering procedural sedation, though there is still controversy around the safety of a nurse administered propofol sedation (NAPS) program. Applicable professional organizations have provided statements supporting NAPS by a trained and competent nurse under the direction of an appropriately credentialed proceduralist.
View Article and Find Full Text PDFJ Perioper Pract
December 2024
Department of Anesthesia and Surgical Intensive Care, Alexandria Faculty of Medicine, Alexandria, Egypt.
Background: Recently, fentanyl has become prevalent as a sedative premedication.
Methods: A non-inferiority parallel design quadruple-blinded randomised controlled trial of 1- to 7-year-old children scheduled for elective cardiac surgery was conducted. Participants were assigned a 1:1 allocation ratio to a control group ( = 50) given a parenteral formulation of midazolam 0.
Clin Transl Sci
December 2024
Department of Experimental and Clinical Pharmacology, College of Pharmacy, University of Minnesota, Minneapolis, Minnesota, USA.
Unpredicted responses to sedatives and analgesics are common in critically ill patients on mechanical ventilation (MV) and may be attributed to genetic variation. Our primary aim was to investigate the association between the pharmacogenomic (PGx) variation and sedation outcomes. The secondary aim was to capture intensive care unit (ICU) participants' perceptions of PGx.
View Article and Find Full Text PDFCureus
November 2024
Department of Pathology, Okayama University Hospital, Okayama, JPN.
A 71-year-old man with follicular lymphoma of the right inguinal lymph node was referred to our hospital owing to mediastinal lymph node enlargement (left #12). The patient had a history of cyclosporine (CYS-A) and steroid therapy for fibrotic hypersensitivity pneumonitis. Endobronchial ultrasound-transbronchial aspiration and endobronchial ultrasound-guided intranodal forceps biopsy (EBUS-IFB) were performed under conscious sedation using midazolam and fentanyl.
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