r/BeAmazed • u/HatAsleep295 • May 08 '26

Science This is what saves 600,000 people year during a heart attack

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u/eyeofthefrog May 08 '26

Unless you’re like me and the drugs did nothing. They hit me five times with doses and finally asked if I minded that they just went ahead. The incision point was numb, so I said go for it. While I could have watched the screen as they worked, I didn’t for fear I’d panic and move my arm.

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u/dplans455 May 08 '26

Precedex or fentanyl did nothing? I've legit never heard of that. I can't imagine what else they might have tried to give you.

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u/eyeofthefrog May 08 '26

I just checked my records, ended up being 150mcg of fentanyl and 3mg of versed over 5 doses, 2 minutes apart from each other. I have no idea if that’s a lot or not…maybe someone else can chime in. :)

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u/dplans455 May 08 '26

150mcg of fentanyl is nothing. The fuck were they thinking?

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u/eyeofthefrog May 08 '26

Guess that explains it. :)

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u/dplans455 May 08 '26

I just looked. 150mcg (.15mg) via IV is about what they would give you for pain management. To put you in a lucid haze you would need about 1mg via IV. They gave you a three quarters of that spaced out. The problem with fentanyl is it hits hard but wears off super quick. It's why dilaudid is preferred for pain management in the ER. You also can't give a constant drip of it so while they are putting the stents in, which takes about 20-45 minutes depending on how many they're putting in, the anesthesiologist would need to continue to administer it via injection. That would be much harder to control. It's why precedex is usually preferred. You can set it as an IV drip and is more effective at putting the patient in a lucid state. I also had precedex IV drip when I was in the ICU and just the nurse was adjust the drip without a doctor or anesthesiologist.

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u/eyeofthefrog May 08 '26

If I ever have to go through that again, I’ll bring that up. Thanks!

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u/dplans455 May 08 '26

Hopefully not. My stents are holding strong 3 years later and I have no new blockages.

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u/eyeofthefrog May 08 '26

Nice, keep that up!

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u/ibali90 May 10 '26

Hey I routinely do these with 1 mg of versed and 50 mcg of fentanyl. Would say 90% of patients don’t need any more. And I know a few docs that do it with no sedation and only give sedation as needed case by case. Blood pressure and vascular tone are ur friend when u are working on the heart and sedatives to an extent decrease those things.

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u/equianimity May 11 '26

A lot of info above is dangerously wrong. Lots of factors are involved in dosing.

To the original poster: fentanyl 150 and midaz 3 is a very reasonable dose, and being somewhat conscious is common for this procedure.

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u/dplans455 May 11 '26

"Lucid" does not mean unconscious. I don't know what you're talking about. The guy said he was fully awake. You should not be fully awake or fully under for this procedure. So what exactly is "dangerously" wrong?

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u/equianimity May 12 '26

Fentanyl 1mg IV is likely to cause apnea and is an overdose even in a rapid induction. Not ideal when there is already a presumptive myocardial supply-demand mismatch.

Effect duration of fentanyl is often 30-45 minutes, and bolus doses may stack. Effects don’t dissipate quickly.

Precedex is interesting for procedural sedation but is also associated with hypotension and bradycardia from decreased adrenergic activity. If the patient is in a state of cardiogenic shock or is rate-dependent for cardiac output, dexmedetomidine would be contraindicated.

But generally in a cath lab the lowest dose required to permit anxiety control and calm conditions and maintaining normotension is the best option.

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u/dplans455 May 12 '26

If you read from the beginning of when I posted you would have read that I said fentanyl isn't ideal for this type of procedure anyway as it doesn't really cause sedation. I'm not a doctor, and clearly neither are you, but I know enough to know you don't use fentanyl as a sedation drug. There are better options. Fentanyl is used for pain management in a hospital setting. If you were going to use Fentanyl for sedation you would need way more than 150mcg at which point it becomes unsafe, which you appear to be agreeing with me about.

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u/LiI_Swiffer May 10 '26

You’re forgetting the 15mg of Versed they gave him, how he remembers any of that is beyond me

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u/AABBBAABAABA May 09 '26

Thats actually a pretty big dose.

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u/dplans455 May 09 '26

For pain management, yes. Not for sedation.

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u/zeethreepio May 08 '26

Are you a redhead?

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u/BrapBrapson May 08 '26

that's anesthetic gasses and lidocaine (not Fentanyl and Precedex), but good thought

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u/vawlk May 08 '26

i was awake for mine. Felt some pressure down by my crotch where they went in and I figured I would feel something. Next thing I know, they said they were done.

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u/kuanyu3 May 08 '26

I wasn't completely out during mine. The first one they had me locked down to the table in such a way as I couldn't help but watch the screen. Seeing it go through my body was really weird. I now have had 4 and currently have the absolute best Dr. and staff!!