Flunitrazepam-fentanyl-induced sedation and analgesia for bone marrow aspiration and needle biopsy in children

Abstract

We describe the use of flunitrazepam and fentanyl to produce sedation and analgesia, as an alternative to general anesthesia, for 96 children with malignancies or hematologic diseases, undergoing 122 bone marrow examinations (BME). In 82 cases there was no reaction to the puncture. Most children had complete amnesia and only two remembered some pain. In 10% the sedation and analgesia was considered inadequate and barbiturate was given; seven out of these 12 children were under the age of 3 years. During 117 procedures the children maintained adequate spontaneous ventilation; in five cases the ventilation was assisted. In 13 cases there were minor side-effects including drowsiness and nausea. One child had a short apnea after the procedure.