GasGasGas - The FRCA Primary Exam Podcast Gas Gas Gas - Fentanyl
Aug 21, 2024
Dive into the intriguing world of fentanyl, from its vital role in anesthesia to its rapid pain control capabilities compared to morphine. Explore dosing strategies for co-induction and innovative administration routes like intranasal and transdermal. Uncover the mechanism of action, side effects, and the unique attributes that make fentanyl suitable for short procedures. Discussion includes its use in head injury cases, the 'wooden chest phenomenon,' and comparisons with morphine, especially for patients with renal failure.
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Tailor Co-Induction Dose To Breathing Needs
- Use fentanyl as a co-induction agent, tailoring dose to whether you want to preserve spontaneous breathing.
- Give 1 mcg/kg or less to preserve breaths, or 100 mcg when you don't mind temporary apnea.
Consultant's Low-Dose Induction Trick
- A consultant gives 40–50 mcg of fentanyl and waits until the patient says they feel it before inducing with propofol.
- This approach preserves spontaneous breathing and speeds turnover in short cases.
Choose Fentanyl For Fast Pain Control
- Use fentanyl for rapid analgesia in acute pain situations because onset is within minutes.
- Prefer fentanyl over morphine in resus when you need quick effect and predictable early control.