1. I work on a small PP unit. Pharmacy is closed at night. Pain mgmt ordered Fentanyl PCA. We have no policy on this. Charge RN called in anes. to mix. We both were uncomfortable starting this potent drug. Any comments?
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  3. by   911fltrn
    Fentanyl is an excellent narcotic pain reliever. (100 mcg and their eyes role back in their heads) Advanced airway management is a must. Used to use fentanyl drips to prevent the need for paralyzing patients. As for mixing the drip, never mix or hang a drug your not comfortable using. You did the right thing by seeking assistance. Maybe you can educate yourself (possibly with pharmacy's help) so that next time you wont be uncomfortable!
  4. by   moz
    I know its used in our epidural pca's here, but I personally never gave it as a pca. I am curious to why this drug was chosen and what you usually use.
  5. by   webbiedebbie
    Labor and Deliver has the drug. We had to get 6 vials from them. Pain mgmt chose this drug. Not usually used on our floor. That's why we were hesitant about using it.
  6. by   kmchugh
    Fentanyl is a potent narcotic, which can be used in a PCA. It has the same properties of other narcotics, including pain relief, sedation, and can cause itching (not generally an allergic reaction). It is often used in anesthesia as the narcotic administered on induction, but has a couple of side effects you should be aware of.

    First, it is MUCH more potent than morphine or demerol, therefore doses are measured in micrograms rather than milligrams. It can also, in larger doses can cause a chest rigidity, and the patient cannot be ventilated, even with an ambu bag. The best remedy for this rigidity is to administer a paralytic i.e. succinlycholine. (I've seen this effect in as small a dose as 4 cc/200 mcg of fentanyl.)

    Although fentanyl is a pretty cheap drug, morphine is much cheaper, and most nurses are more familiar with the dosages and uses of morphine. This leaves me wondering why the pain management people ordered fentanyl over morphine.

    Kevin McHugh