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December 1988

'Anesthetic' Doses of Fentanyl

Author Affiliations

Knoxville, Tenn

Arch Surg. 1988;123(12):1525. doi:10.1001/archsurg.1988.01400360095018

To the Editor.—I read with interest the article in the January 1988 issue of the Archives by Klausner et al,1 after this article was brought to my attention by a surgical colleague. Certainly respiratory depression and muscular rigidity are well-described side effects from the administration of fentanyl2-4 and other narcotic drugs.

Two points need to be made regarding this article. First, the use of 55 to 75 μg/kg of fentanyl in a general surgical population is not a moderate dose but is a high dose fentanyl anesthesia. It is in these doses that fentanyl can be used as the primary anesthetic agent and are, therefore, considered not analgetic doses but "anesthetic" doses. I feel there is a great potential for confusion in the medical community if this is not clearly understood. Second, any patient receiving 55 to 75 μg/kg of fentanyl for a surgical procedure of