Abstract
The Sri Lankan Journal of Anaesthesiology is the official journal of the College of Anaesthesiologists of Sri Lanka. It publishes clinical investigations, research articles, audits, case reports, review articles and CME articles relating to anaesthesiology, critical care and pain. It is published bi annually in January and June. Sri Lankan Journal of Anaesthesiology is included on DOAJ and Scopus.
Highlights
High dose intravenous fentanyl administration has been associated with chest wall rigidity resulting in ineffective ventilation.[1]
We describe a case of postpartum tubal ligation who developed apnoea intra operatively under spinal anesthesia following administration of intravenous midazolam and fentanyl and could not be ventilated
A combination of midazolam and fentanyl is commonly used for conscious sedation in patients undergoing surgery under regional anaesthesia
Summary
S Kiran1*, V Aggarwal[2], N Gupta[3] Senior Professor[1], Resident2,, Department of Anaesthesia and Critical Care, Post Graduate Institute of Medical Sciences, Rohtak, India. Resident[3], Department of Anaesthesia, Sriramachandra Medical. Low dose midazolam and fentanyl are commonly used to provide conscious sedation during regional anaesthesia. Inability to ventilate because of chest wall rigidity following administration of high dose fentanyl has been described. We report a case where midazolam and fentanyl were used to provide sedation and supplementary analgesia during spinal anaesthesia. Anaesthetic circuit was applied, airway was maintained using face mask 100% oxygen was commenced, and CPAP was initiated. After few seconds, she could be ventilated and her spontaneous respiratory efforts returned. Glottic closure secondary to fentanyl administration was thought to be a plausible explanation
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