Can someone please explain how each medication works and what part of the body the have effects on? Fentanyl, versed, ketamine. Iv moderate sedation
In: 3
It’s often called twilight sedation. As I’m not general anesthesia. The biggest difference is under general, you are given heavy sedatives and paralytic, such a as
succinylcholine, etomidate, rocuronium etc… you must be intubated and be under the care of an anesthesiologist.
As a paramedic. I would use all the above drugs including benzos like versed, Ativan and Valium. Opiates like fentanyl, morphine and dilaudid. Ketamine is an amazing drug we use more and more for severe pain and for sedation.
You don’t need to be intubated under twilight sedation. You may (should) be given oxygen via nasal cannula or NRB mask. Twilight is safer than a general and you can be very comfortable. If it’s done properly your going to not be conscious or nearly. Another amazing drug for twilight sedation is propofol. It looks like milk and it’s the drug Michael Jackson died on. That was a crazy thing. It’s a very very safe drug when used properly. It has a very fast half life and wears off completely in minutes. Awing drug. Heavy O2 use is indicated however.
All these drugs are CNS depressants. Which means they slow down and depress the central nervous system. You become very tired and loopy, euphoric (high) in some cases. Depends on the level of sedation. If it’s light sedation you will be loopy but awake. Able to look around and understand what’s happening. If it’s moderate you may be in and out of being awake. If it’s heavy you will just be asleep and unable to fight it.
Ketamine is a bit different. You will be awake but so disassociated from reality you could have your leg cut off and not feel a thing. I star the s to use ketamine for patients in severe pain. It’s much much more effective than super potent opiates. And usually safer. It’s very hard to explain the effects. Don’t be afraid of it. That’s for sure. You will be very very peaceful and at ease.
Usually the first drug given is a benzodiazepine like versed or Ativan. That will calm you down very very quickly and effectively.
Propofol you are immediately knocked out. Total blackness and you just suddenly wake up when it’s over. Like being asleep.
The opiates you feel very euphoric and loopy. If heavy doses are given you will go to sleep.
Any specific questions please don’t hesitate to ask. Hope this helps. Cheers.
-I worked the road as a paramedic for 9 years. Know my drugs…
Fentanyl is an opioid that blocks pain receptors in your brain. It is used to prevent pain during and immediately after the surgery.
Versed (midazolam) is a benzodiazepine that acts on the brain to reduce stress and anxiety going into surgery. It also promotes sleepiness and memory loss (which is a good thing in this case – remembering a surgery in detail can be traumatic).
Ketamine is a sedative that also acts on the brain and central nervous system. At anesthetic doses, it blocks the production of glutamate, which makes it harder for neurons to communicate with each other. This slows down brain activity and can help induce unconsciousness for surgery.
The thing with them is that we know what they do at a higher level in that they suppress pain, suppress consciousness and so on. There are highly trained people who can work out what you need, how much and so on. Surgeries are performed with them, etc, etc, etc.
We know that they can do things like suppress certain parts of the central nervous system and so on……… but the question of how they work on a deep level of what is actually going on to do all that is that we don’t really know. We just know that they do.
Latest Answers