MASSACHUSETTS GENERAL HOSPITAL
Department of Pharmacy
Department of Nursing
Critical Care
| Generic Name: | Fentanyl / Midazolam |
| Trade Name: | Fentanyl / Versed |
| Action: | Opiate Analgesic / Sedative Hypnotic |
| Indications: | Sedation |
| Administration Guidelines: | |
| Usual Dosage Range and Route: | 5 - 10 ml / hour via syringe based, variable flow, continuous microinfusion pump as titrated to patient response |
| Standard Concentration: |
MICROINFUSION: 2 mg of fentanyl
(40ML OF 0.05 mg/ml) with 10 mg midazolam (10 ml of 1 mg/ml) |
| Special Considerations: | - For sedation
purposes, fentanyl must be administered in the presence of a physician
trained in airway management
- Drug tolerance may result in need for frequent evaluation of patient response - Rapid injection will result in increased incidence of side effects up to and including respiratory arrest - For patients maintained on fentanyl for analgesia, monitoring of untoward respiratory effects should be observed during dose titration. Consideration of an alternative agent should be explored as other medications provide superior analgesia. |
| Precautions and Side Effects: | - When used as an analgesic,
fentanyl should not be abruptly withdrawn and alternative agents should
be considered for pain management. - Hypotension - Respiratory Depression - With drawal symptoms after 48 to 72 hours of use - Paralytic ileus - Bradycardia - Hallucinations |