Quick tip for families in Intensive Care: What are the alternatives to opiates in ICU?

https://intensivecarehotline.com/blog/quick-tip-for-families-in-intensive-care-what-are-the-alternatives-to-opiates-in-icu/Show more

Quick tip for families in Intensive Care: What are the alternatives to opiates in ICU?

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Hi, it’s Patrik Hutzel from intensivecarehotline.com with another quick tip for families in intensive care.

So Ruth asked a question saying, “Are there any alternatives to opiates, such as fentanyl or morphine in intensive care when someone is in an induced coma, on ventilation with a breathing tube?” Now, it’s a great question to ask. And unfortunately, there are not many alternatives.

So when someone is ventilated with a breathing tube or an endotracheal tube in intensive care, they automatically go into an induced coma. And the standard medications at the moment are, propofol and midazolam or Versed for sedation. And then either morphine or fentanyl for opiates, to enable a patient, to be able to tolerate mechanical ventilation because it’s very, very uncomfortable.

Now, have I seen many alternatives?

So when someone, for example, is allergic to morphine or to fentanyl, you are usually using the other. Now there are some other alternatives such as oxycodone or hydromorphone, but they are also classified as opiates as well.

So unfortunately, there aren’t many alternatives. In some situations, somebody might use Dynastat or parecoxib as an alternative. But that’s not an opiate, but that can cause kidney failure on the other end. And in some countries, it is even banned.

Continuation...
https://intensivecarehotline.com/blog/quick-tip-for-families-in-intensive-care-what-are-the-alternatives-to-opiates-in-icu/