analgesia before cardioversion

[mrnewman]

I am about to take nclex, and I am really confused about cardioversion, I also did looked up a lot but not clear result about it, so I am here and hoping to get the help. I know the most important about cardioversion is syn button and pt pain. I know for sure that benzo sedation is given before procedure, but some say should give narcotic, and say should not. I am really want to know should or not. thanks ahead!

[mrnewman]

Thank you! I looked up a little bit more also. so most likely to give sedation; and narcotic is more depends on the doc, pt's pain perceptive, and the voltages. make me feel much better, thanks again.

[mrnewman]

and Like Altra mentioned, post-monitoring also affect the doc's decision.

[MaudKennedy]

It's always good form, when possible, to give analgesia and sedation prior to a shock, whether it be elective or emergent. In emergent cardioversions however it may frequently not be possible.

There's an interesting argument to be had as to whether or not patients should get versed and analgesia when they are premedicated for a cardioversion, or does the amnesic properties of versed mean that it doesn't matter if the patient experiences pain since they won't remember experiencing pain. Some Docs argue that if they aren't going to remember it anyway, it doesn't matter how much they suffer with the shock. It's sort of like if a tree falls in the woods and no one is there to here it.... If a patient has pain but then has no recollection of having pain, did they really have pain?

i

If someone is drugged with ghb and doesn't remember their assault,were they really raped? Sorry but that's the same reasoning. If a patient can't get pain medication for medical reasons then so be it but "they won't remember it so their pain doesn't matter" is very concerning and makes you wonder if versed is used in patients best interests or for staff convenience ,to gain compliance, to be able to make comments about the patient they'drather them to forget or to avoid to give pain control,especially for procedures like endoscopies or colonoscopies.

There are several testimonies on the internet about procedures processed with just versed,even on here because "patients won't remember a thing"

[StayLost, BSN, RN]

The gold standard for Cardioversion is Propofol Rapid IVP right before shock is delivered. There are times when a patient is symptomatic and can not tolerate the hypotensive effects of proposal, which we would give fentanyl and versed. And then there are times we shock because we can't wait or the patient will arrest.