Efficacy and safety of intravenous fentanyl administered by ambulance personnel.

Abstract:

BACKGROUND:Management of pain in the pre-hospital setting is often inadequate. In 2011, ambulance personnel were authorized to administer intravenous fentanyl in the Central Denmark Region. The aim of this study was to evaluate the efficacy and safety of intravenous fentanyl administered by ambulance personnel. METHODS:Pre-hospital medical charts from 2348 adults treated with intravenous fentanyl by ambulance personnel during a 6-month period were reviewed. The primary outcome was the change in pain intensity on a numeric rating scale (NRS) from before fentanyl treatment to hospital arrival. Secondary outcomes included the number of patients with reduction in pain intensity during transport (NRS ≥ 2), the number of patients with NRS > 3 at hospital arrival, and potential fentanyl-related side effects. RESULTS:Fentanyl reduced pain from before treatment (8, IQR 7-9) to hospital arrival (4, IQR 3-6) (NRS reduction: 3, IQR 2-5; P = 0.001), 79.3% of all patients had a reduction in > 2 on the NRS during transport, and 58.4% of patients experienced pain at hospital arrival (NRS > 3). Twenty-one patients (0.9%) had oxygen saturation < 90%. A decrease in Glasgow Coma Scale was seen in 31 patients (1.3%) and hypotension observed in 71 patients (3.0%). CONCLUSION:Intravenous fentanyl caused clinically meaningful pain reduction in most patients and was safe in the hands of ambulance personnel. Many patients had moderate to severe pain at hospital arrival. As the protocol allowed higher doses of fentanyl, feedback on effect and safety should be part of continuous education of ambulance personnel.

authors

Friesgaard KD,Nikolajsen L,Giebner M,Rasmussen CH,Riddervold IS,Kirkegaard H,Christensen EF

doi

10.1111/aas.12662

subject

Has Abstract

pub_date

2016-04-01 00:00:00

pages

537-43

issue

4

eissn

0001-5172

issn

1399-6576

journal_volume

60

pub_type

杂志文章
  • Intrathecal ropivacaine 5 mg/ml for outpatient knee arthroscopy: a comparison with lidocaine 10 mg/ml.

    abstract:PURPOSE:The aim of this prospective, randomised, blind study was to compare the evolution of spinal block produced with 50 mg lidocaine 10 mg/ml and 10 mg ropivacaine 5 mg/ml for outpatient knee arthroscopy. METHODS:Thirty outpatients undergoing knee arthroscopy received 50 mg of lidocaine 10 mg/ml (n=15) or 10 mg of ...

    journal_title:Acta anaesthesiologica Scandinavica

    pub_type: 杂志文章,随机对照试验

    doi:10.1111/j.1399-6576.2008.01815.x

    authors: Fanelli G,Danelli G,Zasa M,Baciarello M,Di Cianni S,Leone S

    更新日期:2009-01-01 00:00:00

  • Anaesthesia for computerised tomography of the brain in children: a comparison of propofol and thiopentone.

    abstract::Propofol (2,6-di-isopropylphenol) 1.5-2.0 mg/kg i.v. was compared with thiopentone 3.0-4.0 mg/kg i.v. as an induction agent in anaesthesia for computerised tomography (CT) of the brain in children. Both induction agents were combined with diazepam 0.2 mg/kg i.v. Thirty children (ASA physical status I-II) aged 3 to 10 ...

    journal_title:Acta anaesthesiologica Scandinavica

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1111/j.1399-6576.1989.tb02884.x

    authors: Valtonen M

    更新日期:1989-02-01 00:00:00

  • Breathing mechanics, dead space and gas exchange in the extremely obese, breathing spontaneously and during anaesthesia with intermittent positive pressure ventilation.

    abstract::Breathing mechanics and gas exchange were studied in 10 extremely obese subjects (average weight 138 kg) prior to and during anaesthesia with mechanical ventilation. Breathing mechanics were analysed from measurements of transpulmonary pressure (during anaesthesia, trans-chest wall pressure as well) inspiratory gas fl...

    journal_title:Acta anaesthesiologica Scandinavica

    pub_type: 杂志文章

    doi:10.1111/j.1399-6576.1976.tb05036.x

    authors: Hedenstierna G,Santesson J

    更新日期:1976-01-01 00:00:00

  • Peroperative depth of anaesthesia may influence postoperative opioid requirements.

    abstract:BACKGROUND:Studies on monitoring the depth of anaesthesia have shown that with the use of these monitors the peroperative consumption of anaesthetics can be reduced. Studies have also indicated that the peroperative depth of anaesthesia may affect the postoperative course. The purpose of this study was to evaluate a po...

    journal_title:Acta anaesthesiologica Scandinavica

    pub_type: 临床试验,杂志文章

    doi:10.1111/j.1399-6576.2005.00598.x

    authors: Henneberg SW,Rosenborg D,Weber Jensen E,Ahn P,Burgdorff B,Thomsen LL

    更新日期:2005-03-01 00:00:00

  • Ephedrine in the cat lung vasculature.

    abstract:BACKGROUND:Ephedrine is one of the most commonly used non-catecholamine sympathomimetic agents. It is used in operating rooms and critical care settings worldwide. While it has many side effects, its ability to rapidly raise blood pressure makes it an ideal agent to maintain homeostasis as well as in emergency situatio...

    journal_title:Acta anaesthesiologica Scandinavica

    pub_type: 杂志文章

    doi:10.1034/j.1399-6576.2003.00185.x

    authors: Fields AM,Richards TA,Ibrahim IN,Kaye AD

    更新日期:2003-09-01 00:00:00

  • Safety aspects of delivery and monitoring of nitric oxide during mechanical ventilation.

    abstract::In the presence of oxygen NO is oxidised to NO2, which is toxic in higher concentrations. In this technical investigation, we evaluated a dosage system, modified from Stenqvist et al. 1993 (1), regarding NO and NO2 levels. NO was administered before the ventilator and NO2 scavenged using a soda little absorber in the ...

    journal_title:Acta anaesthesiologica Scandinavica

    pub_type: 杂志文章

    doi:10.1111/j.1399-6576.1996.tb04437.x

    authors: Westfelt UN,Lundin S,Stenqvist O

    更新日期:1996-03-01 00:00:00

  • Neurologic deficits and arachnoiditis following neuroaxial anesthesia.

    abstract::Of late, regional anesthesia has enjoyed unprecedented popularity; this increase in cases has brought a higher frequency of instances of neurological deficit and arachnoiditis that may appear as transient nerve root irritation, cauda equina, and conus medullaris syndromes, and later as radiculitis, clumped nerve roots...

    journal_title:Acta anaesthesiologica Scandinavica

    pub_type: 杂志文章,评审

    doi:10.1034/j.1399-6576.2003.470102.x

    authors: Aldrete JA

    更新日期:2003-01-01 00:00:00

  • Selective lumbar epidural block in labour. A clinical analysis.

    abstract::Segmental epidural analgesia (T10-T12) was performed in 418 parturients, using a 4-6 ml dose of 0.5% bupivacaine, with or without adrenaline. Seventy per cent of parturients were primiparas and 30% had histories, or signs, of possible uteroplacental insufficiency. Our aim was to relieve pain during the long passive op...

    journal_title:Acta anaesthesiologica Scandinavica

    pub_type: 杂志文章

    doi:10.1111/j.1399-6576.1977.tb01207.x

    authors: Hollmén A,Jouppila R,Pihlajaniemi R,Karvonen P,Sjöstedt E

    更新日期:1977-01-01 00:00:00

  • Experience with a "Feed and Swaddle" program in infants up to six months of age.

    abstract:BACKGROUND:Feed and swaddle is a technique in which an infant is fed and allowed to fall asleep to facilitate diagnostic imaging. This study reviews our experience and diagnostic success in premature and term infants up to 6 months old undergoing brain magnetic resonance imaging (MRI) using a feed and swaddle technique...

    journal_title:Acta anaesthesiologica Scandinavica

    pub_type: 杂志文章

    doi:10.1111/aas.13471

    authors: Templeton LB,Norton MJ,Goenaga-Díaz EJ,McLaughlin DH,Zapadka ME,Templeton TW

    更新日期:2020-01-01 00:00:00

  • Effect of aminophylline on bispectral index.

    abstract:BACKGROUND:The aim of the present study was to investigate the effects of aminophylline on BIS as well as clinical recovery in patients anesthetized with sevoflurane. METHODS:Sixty patients with status of ASA I-II scheduled for elective surgery were enrolled in this study. Anesthesia was induced by 2 mg kg(-1) of prop...

    journal_title:Acta anaesthesiologica Scandinavica

    pub_type: 临床试验,杂志文章

    doi:10.1111/j.0001-5172.2004.00350.x

    authors: Turan A,Memiş D,Karamanlýodthlu B,Pamukçu Z,Süt N

    更新日期:2004-04-01 00:00:00

  • Influence of "lytic cocktail" on blood flow and oxygen consumption in the rat brain.

    abstract::The influence of a sedative dose of "lytic cocktail" (chlorpromazine, promethazine and pethidine) on cerebral blood flow (CBF) and oxygen consumjtion (CMRO2) was tested in artificially ventilated rats, maintained on either 70% N2 or 70% N2O. When given alone, the lytic cocktail had no significant effect on CBF or CMRO...

    journal_title:Acta anaesthesiologica Scandinavica

    pub_type: 杂志文章

    doi:10.1111/j.1399-6576.1978.tb01332.x

    authors: Berntman L,Carlsson C

    更新日期:1978-01-01 00:00:00

  • A bolus dose of 1.5 mg/kg amrinone effectively improves low cardiac output state following separation from cardiopulmonary bypass in cardiac surgical patients.

    abstract:BACKGROUND:The aim of this study was to evaluate the efficacy of 1.5 mg/kg bolus of amrinone on low cardiac output (CO) state following emergence from cardiopulmonary bypass (CPB) in cardiac surgical patients. METHODS:Immediately after emergency from CPB, 14 patients with a cardiac index (CI) less than 2.2 l.min-1.m-2...

    journal_title:Acta anaesthesiologica Scandinavica

    pub_type: 杂志文章

    doi:10.1111/j.1399-6576.1998.tb05329.x

    authors: Kikura M,Levy JH,Bailey JM,Shanewise JS,Michelsen LG,Sadel SM

    更新日期:1998-08-01 00:00:00

  • Evaluation of a recruitment maneuver with positive inspiratory pressure and high PEEP in patients with severe ARDS.

    abstract:BACKGROUND:To evaluate the effect of a recruitment maneuver (RM) with constant positive inspiratory pressure and high positive end-expiratory pressure (PEEP) on oxygenation and static compliance (Cs) in patients with severe acute respiratory distress syndrome (ARDS). METHODS:Eight patients with ARDS ventilated with lu...

    journal_title:Acta anaesthesiologica Scandinavica

    pub_type: 杂志文章

    doi:10.1111/j.0001-5172.2004.0305.x

    authors: Póvoa P,Almeida E,Fernandes A,Mealha R,Moreira P,Sabino H

    更新日期:2004-03-01 00:00:00

  • Ethical issues in intensive care--a survey among Scandinavian intensivists.

    abstract:BACKGROUND:The general principles of medical ethics are universally accepted. In practice, however, there is variation on how these principles are interpreted by people with different cultural backgrounds. The aim of this study was to document the views of Scandinavian intensive care physicians on intensive care unit (...

    journal_title:Acta anaesthesiologica Scandinavica

    pub_type: 杂志文章

    doi:10.1111/j.1399-6576.2005.00799.x

    authors: Tallgren M,Klepstad P,Petersson J,Skram U,Hynninen M

    更新日期:2005-09-01 00:00:00

  • Patient fear of anesthesia complications according to surgical type: potential impact on informed consent for anesthesia.

    abstract:BACKGROUND:Past research has explored patients' expectations about the informed consent process. However, it is currently unknown if the complexity of the surgical procedure influences the type of anesthesia-related risks that patients wish disclosed. This study explored fears of anesthesia-related complications and wh...

    journal_title:Acta anaesthesiologica Scandinavica

    pub_type: 杂志文章

    doi:10.1111/aas.12413

    authors: Burkle CM,Mann CE,Steege JR,Stokke JS,Jacob AK,Pasternak JJ

    更新日期:2014-11-01 00:00:00

  • Effects of prolonged anesthesia with enflurane or halothane on renal function in dogs.

    abstract::Elevated serum inorganic fluoride levels (60-300 mumol/l), maintained over 6 h, influenced renal function in beagle dogs. Changes in water reabsorption were seen with an increased urine flow and free water clearance and decreased urinary concentration capacity. Possible nephrotoxicity as an effect of inorganic fluorid...

    journal_title:Acta anaesthesiologica Scandinavica

    pub_type: 杂志文章

    doi:10.1111/j.1399-6576.1981.tb01642.x

    authors: Wickström I,Stefansson T

    更新日期:1981-06-01 00:00:00

  • The effects of hydroxyethyl starch solutions on thromboelastography in preoperative male patients.

    abstract:BACKGROUND:Hydroxyethyl starches (HES) have been shown to decrease clot strength and to increase coagulation times assessed by thromboelastography (TEG). HES with minimal anticoagulant side-effects is beneficial for plasma volume expansion in the perioperative setting. A comparison of the in vivo effects of high, middl...

    journal_title:Acta anaesthesiologica Scandinavica

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1034/j.1399-6576.2003.470112.x

    authors: Felfernig M,Franz A,Bräunlich P,Fohringer C,Kozek-Langenecker SA

    更新日期:2003-01-01 00:00:00

  • Light-guided intubation via the intubating laryngeal mask using a prototype illuminated flexible catheter. Clinical experience in 400 patients.

    abstract:BACKGROUND:The transillumination of the soft tissues of the neck using lighted stylets has been used as an aid for tracheal intubation. We evaluated the efficacy and safety of a prototype illuminated flexible catheter to facilitate light-guided intubation through the intubating laryngeal mask. METHODS:The illuminated ...

    journal_title:Acta anaesthesiologica Scandinavica

    pub_type: 临床试验,杂志文章

    doi:10.1034/j.1399-6576.2000.440818.x

    authors: Dimitriou V,Voyagis GS

    更新日期:2000-09-01 00:00:00

  • Severe ARDS may cause right heart failure with extreme hepatomegaly but without hepatic failure.

    abstract::A young trauma patient developed severe adult respiratory distress syndrome (ARDS), right heart failure, hepatic congestion and an extreme hepatomegaly but no hepatic failure. The patient needed 100% oxygen during ventilatory support for 80 days and was weaned from the ventilator after more than 100 days. The hepatome...

    journal_title:Acta anaesthesiologica Scandinavica

    pub_type: 杂志文章

    doi:10.1034/j.1399-6576.2002.460724.x

    authors: Søreide E,Harboe S,Søndenaa K

    更新日期:2002-08-01 00:00:00

  • Comparative potency and speed of onset of fazadinium and d-tubocurarine.

    abstract::The potency and speed of onset of fazadinium and d-tubocurarine have been compared at three cumulative doses. Wtih thiopentone as the induction agent, the dose ratio fazadinium/d-tubocurarine ranged from 1.2 to 1.3 for single twitch reduction and from 1.1 to 1.2 for reduction of tetanus. The times taken for the develo...

    journal_title:Acta anaesthesiologica Scandinavica

    pub_type: 杂志文章

    doi:10.1111/j.1399-6576.1979.tb01459.x

    authors: Hussain SZ,Healy TE,Birmingham AT

    更新日期:1979-08-01 00:00:00

  • Pentoxifylline attenuates the increase in whole blood viscosity after transfusion.

    abstract:BACKGROUND:Pentoxifylline improves tissue oxygenation and intestinal blood flow in models of haemorrhagic shock, and it has been used for the treatment of intermittent claudication due to its beneficial effects on haemorheology. We investigated the effects of pentoxifylline on whole blood viscosity during packed red-bl...

    journal_title:Acta anaesthesiologica Scandinavica

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1111/j.1399-6576.2004.00547.x

    authors: Bacher A,Eggensperger E,Koppensteiner R,Mayer N,Klimscha W

    更新日期:2005-01-01 00:00:00

  • Haemodynamics and myocardial oxygenation during anaesthesia for coronary artery surgery: comparison between enflurane and high-dose fentanyl anaesthesia.

    abstract::Changes in central and coronary haemodynamics and myocardial oxygenation during anaesthesia induction, intubation, skin incision and sternotomy were studied in 24 patients undergoing a coronary artery bypass grafting operation under either high-dose fentanyl or enflurane anaesthesia. The anaesthesia induction caused n...

    journal_title:Acta anaesthesiologica Scandinavica

    pub_type: 杂志文章

    doi:10.1111/j.1399-6576.1985.tb02234.x

    authors: Heikkilä H,Jalonen J,Arola M,Laaksonen V

    更新日期:1985-07-01 00:00:00

  • The influence of nitrous oxide on recovery of bowel function after abdominal hysterectomy.

    abstract::The influence of nitrous oxide on the recovery of bowel function was studied in 36 patients anaesthetised for elective abdominal hysterectomy with or without salpingo-oophorectomy. Patients were randomly assigned to receive either isoflurane in nitrous oxide and 30% oxygen (N2O group) or isoflurane in air and 30% oxyg...

    journal_title:Acta anaesthesiologica Scandinavica

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1111/j.1399-6576.1993.tb03791.x

    authors: Pedersen FM,Wilken-Jensen C,Knudsen F,Lindekaer AL,Svare EI

    更新日期:1993-10-01 00:00:00

  • Point-of-care analyses of blood samples from intraosseous access in pre-hospital critical care.

    abstract:BACKGROUND:Intraosseous (IO) access is used for fluid and medication administration in emergency situations when difficulties with vascular access are encountered. IO access would be readily available to take samples for point-of-care (POC) analysis, but there is scarce evidence about the reliability of POC analysis of...

    journal_title:Acta anaesthesiologica Scandinavica

    pub_type: 杂志文章

    doi:10.1111/aas.13443

    authors: Jousi M,Björkman J,Nurmi J

    更新日期:2019-11-01 00:00:00

  • A new nomogram facilitating adequate haemodilution.

    abstract::When using deliberate haemodilution to a certain haematocrit value (Hct), the appropriate preoperative blood volume of the patient must be determined and matched with the transfusion volume at a certain blood loss. In order to facilitate such calculations a nomogram was constructed, aiming for a final Hct of 33%. Preo...

    journal_title:Acta anaesthesiologica Scandinavica

    pub_type: 杂志文章

    doi:10.1111/j.1399-6576.1986.tb02418.x

    authors: Zetterström H,Wiklund L

    更新日期:1986-05-01 00:00:00

  • Using a simplified pre-hospital 'MET' score to predict in-hospital care and outcomes.

    abstract:BACKGROUND:Medical emergency team (MET) activation criteria serve as a predictor of serious adverse events on hospital wards and in the emergency department (ED). We aimed to determine whether in-hospital MET activation criteria would be useful in identifying patients at risk in pre-hospital care. METHODS:The data wer...

    journal_title:Acta anaesthesiologica Scandinavica

    pub_type: 杂志文章

    doi:10.1111/aas.12499

    authors: Jokela K,Setälä P,Virta J,Huhtala H,Yli-Hankala A,Hoppu S

    更新日期:2015-04-01 00:00:00

  • Maternal and foetal effects of remifentanil for general anaesthesia in parturients undergoing caesarean section: a systematic review and meta-analysis.

    abstract:BACKGROUND:Remifentanil has been suggested for the induction of general anaesthesia for caesarean section. We aimed to define remifentanil effects on maternal stress response as well as neonatal effects. METHODS:Relevant articles were retrieved by a systematic literature search. Randomized, controlled trials comparing...

    journal_title:Acta anaesthesiologica Scandinavica

    pub_type: 杂志文章,meta分析,评审

    doi:10.1111/j.1399-6576.2012.02723.x

    authors: Heesen M,Klöhr S,Hofmann T,Rossaint R,Devroe S,Straube S,Van de Velde M

    更新日期:2013-01-01 00:00:00

  • A randomised double-blind evaluation of adenosine as adjunct to sufentanil in spinal labour analgesia.

    abstract:BACKGROUND:Intrathecal injection of sufentanil offers labour pain relief of short duration. This double-blind randomised study evaluates if the combination of adenosine to sufentanil could give relevant prolongation (40%) of the duration of sufentanil spinal analgesia. METHODS:Twenty-five healthy parturients requestin...

    journal_title:Acta anaesthesiologica Scandinavica

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1034/j.1399-6576.2003.00110.x

    authors: Rane K,Sollevi A,Segerdahl M

    更新日期:2003-05-01 00:00:00

  • Neutrophil mobility during anaesthesia in children. A trial of ascorbate premedication.

    abstract::In 20 healthy children undergoing elective surgery, mobility of neutrophils, both unstimulated and stimulated by endotoxin, was studied using a millipore filter system with microscopic determination of leading front migration. Paired samples were incubated with 10(-2) mol l-1 calcium ascorbate and ten children also re...

    journal_title:Acta anaesthesiologica Scandinavica

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1111/j.1399-6576.1987.tb02580.x

    authors: Charlton AJ,Harvey BA,Hatch DJ,Soothill JF

    更新日期:1987-05-01 00:00:00

  • Treatment of elevated intracranial pressure with indomethacin: friend or foe?

    abstract::Indomethacin has been suggested as a therapeutic tool to manage elevated intracranial pressure in patients with severe head injury and patients undergoing craniotomy for brain tumors. Indomethacin is a non-selective cyclooxygenase inhibitor. Compared to other cyclooxygenase inhibitors indomethacin has unique effects o...

    journal_title:Acta anaesthesiologica Scandinavica

    pub_type: 杂志文章,评审

    doi:10.1111/j.1399-6576.2005.00647.x

    authors: Rasmussen M

    更新日期:2005-03-01 00:00:00