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Sedation scales are used in medical situations in conjunction with a medical history in assessing the applicable degree of sedation in patients in order to avoid under-sedation (the patient risks experiencing pain or distress) and over-sedation (the patient risks side effects such as suppression of breathing, which might lead to death).
In emergency medicine, safe administration of intranasal fentanyl with a low rate of side effects and a promising pain-reducing effect was demonstrated in a prospective observational study in about 900 out-of-hospital patients. [40] In children, intranasal fentanyl is useful for the treatment of moderate and severe pain and is well tolerated. [41]
Fentanyl provides analgesia and sedative properties; it does not have any amnestic effects. It was commonly used with midazolam for effective PSA prior to propofol and etomidate. The major complication of fentanyl is respiratory depression, which can be made worse when given with other sedative agents.
Additionally, IV sedation is frequently administered as a concoction of several agents including those previously mentioned for induction and maintenance of anesthesia, as well as a benzodiazepine (usually midazolam, but temazepam or flunitrazepam are also used via the oral route [4]) and a narcotic/systemic analgesic such as demerol or fentanyl.
Midazolam is sometimes used for the acute management of prolonged seizures.Long-term use for the management of epilepsy is not recommended due to the significant risk of tolerance (which renders midazolam and other benzodiazepines ineffective) and the significant side effect of sedation. [21]
The most common side effects reported by patients receiving this medication are a sense of extreme "dizziness" (often short lived, a common side effect of other fast-acting synthetic phenylpiperidine narcotics such as fentanyl and alfentanil) and intense itching , often around the face.
In medicine, specifically in end-of-life care, palliative sedation (also known as terminal sedation, continuous deep sedation, or sedation for intractable distress of a dying patient) is the palliative practice of relieving distress in a terminally ill person in the last hours or days of a dying person's life, usually by means of a continuous intravenous or subcutaneous infusion of a sedative ...
Chest wall. Wooden chest syndrome is a rigidity of the chest following the administration of high doses of opioids during anesthesia [1]. [1]Wooden chest syndrome describes marked muscle rigidity — especially involving the thoracic and abdominal muscles — that is an occasional adverse effect associated with the intravenous administration of lipophilic synthetic opioids such as fentanyl [2].