Sedations and analgesia in patients undergoing percutaneous transhepatic biliary drainage.
OBJECTIVE
To present our experience using intravenous sedoanalgesia for percutaneous biliary drainage.


METHODS
This study comprised 100 patients, all of whom were continuously monitored [electrocardiogram (ECG), blood pressure, pulse oxymetry] and received an initial dose of 2mg midazolam followed by 0.02 mg fentanyl. Before every anticipated painful procedure, a maintenance dose of 0.01 mg fentanyl was administered. If the procedure continued and the patient became aware, another 1mg midazolam was given. This was repeated if patients felt pain. A total dose of 0.08 mg fentanyl and 7 mg midazolam was never exceeded. Immediately after the procedure, the nurse was asked to evaluate patients' pain score. The patients were asked 3h later to complete a visual 10-degree pain score scale.


RESULTS
The average dose of fentanyl and midazolam was 0.042 mg (0.03-0.08 mg) and 4.28 mg (2-7 mg), respectively. Only one patient recorded the procedure as painful. The scores given by the attending nurse (1-7 points, mean 2.9) correlated well with those given by the patients (1-6 points, mean 2.72). No complications were noted.


CONCLUSIONS
According to our experience, interventional radiologists practising biliary procedures can administer low doses of midazolam and minimize the doses of fentanyl, without loss of adequate sedation and analgesia.
Hatzidakis
A A
AA
Department of Radiology, University Hospital of Heraklion, Medical School of Crete, University of Crete, Greece. adamhatz@hotmail.com
Charonitakis
E
E
Athanasiou
A
A
Tsetis
D
D
Chlouverakis
G
G
Papamastorakis
G
G
Roussopoulou
G
G
Gourtsoyiannis
N C
NC
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000698:Analgesia / Q000379:methods*; D000701:Analgesics, Opioid / Q000008:administration & dosage; D001649:Bile Duct Diseases / Q000628:therapy*; D016292:Procedural Sedation / Q000379:methods*; D004322:Drainage / Q000379:methods; D004334:Drug Administration Schedule; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage; D016014:Linear Models; D008297:Male; D008874:Midazolam / Q000008:administration & dosage; D008875:Middle Aged; D010147:Pain Measurement; D011446:Prospective Studies; D015641:Radiography, Interventional
D000701:Analgesics, Opioid; D006993:Hypnotics and Sedatives; D008874:Midazolam; D005283:Fentanyl