Fentanyl Gastroscopy

[Creatureofhabit87]

I need to have a gastroscopy on Friday and I am worried about the Fentanyl they give. When I last had fentanyl for pain relief for a procedure, it made me feel like I kept forgetting to breathe. Whenever I said this to the nurse she said I was fine. However I really didn’t enjoy it! Not sure if it was just a feeling as she said my obs were fine. I know it can cause respiratory arrest and I am worried that was going to happen! Any insight?! Thanks!

You can have it without

I know but that scares me just as much as it sounds bloody horrible!!

They will be monitoring you, so if anything does happen( which it shouldn’t as the dose is low) you’re in the right place.
Or as Pp said, try without

You can indeed have it without. In my local hospital you can also have it plus midazolam (my choice, the less that I'm aware or am able remember of these things, the better!)

Remember that your obs will be monitored throughout. If you happened to be hypersensitive to fentanyl such that it slowed your breathing too much, this wouldn't happen suddenly, ie you wouldn't just stop -- your obs would show a slowing down of your resp rate so that the staff could act on this before you ran into trouble. Remember too that the endoscopy suite will have resuscitation equipment to hand - not that you are likely to need it!

Thought it was midazolam

Thanks that’s reassuring! It’s midazolam as well. It was a heart procedure I was having (well an implantation of a device) when I had the fentanyl. The nurse did say all was fine so am sure it’s the feeling more than anything!

fentanyl can cause respiratory depression, but that's why they're monitoring you and why there's a recovery period afterwards. It's a pretty short acting drug and endoscopy sedation (without an anaesthetist present) is usually protocolised to reduce the chance of respiratory problems. In the unlikely event that it gets a bit hairy there is an opioid reversal agent and endoscopy suites will have all the usual resus kit.

They give a very low dose of midazolam now, lower than it used to be. It's enough to calm you down. Let them know your worries but honestly you'll be in very safe hands. You will be monitored. Unfortunately it feels like you can't breathe with the tube down anyway but they will calm and reassure you. Big breaths and it helps.

I had midazolam afaik. No issues.

I can't understand if you had Fentanyl how you remember anything ? I was out like a light on the occasions I have had it. Had my most recent one in Dec.

DH works as an endoscopy nurse and there is always a nurse whose job is to closely monitor your heart rate and respiration

I was coming around from anaesthetic and they asked if I was in pain and I said yes (had just had a defibrillator implanted) and they gave me fentanyl. I then remember dozing off but having to conciously make an effort to breathe.. I thought if I didn’t I was going to stop! I then remember the monitor beeping but they were like no it’s fine! As I was coming around and in recovery a few hours later I can’t remember if I had more fentanyl but I remember thinking I just want to sleep but as soon as I try, I stop breathing!! Who knows, could be the fentanyl or my reaction to anesthesia!

Thanks for this! I’m reassured there’s an opioid reversal agent too!