A colorless odorless liquid hidden at the depths of a puny ampule, this miracle looked back at me gleaming with possibilities. Pummeled into dilution duties early morning all through my fresher year,all I could remember about fentanyl was that it was to be made 10 per CC. The mundane yet imperative act of drug preparation was jived up by frequent possibilities of a drug becoming NA! “Not Available” in a govt setup meant one thing and one thing only..that the drug still gets on the tray no matter the hell you pass through hunting for it! Precious stones and pearls light up a dame’s face, as a first year resident,an ampule of fentanyl sure did the trick for me!
I do not remember the time this word fentanyl doesn’t come up in the OT. Premedication to analgesia to induction to reversal to spinal to epidural to weird skin tattoos for pain relief, we seem to get so obsessed with the drug. Ask an anesthetist dying of pain and his last words would be “fentanyl”.
Scene: surgery OT. Thesis case.. cholecystectomy under GA with specified drug dosage protocol. I break the last ampule of liquid gold (fentanyl),a mammoth 10 ml of it to load it for use. The consultant beside me, looking out for the multitude of errors that I can be capable of, says “ ok, induction!”.The senior resident takes the liquid of joy and pumps it in IV. The Buddha like peace on the patient’s face seems so discerningly uncanny.. I look up and see our stud with a dud of a gall bladder has stopped breathing with dipping vitals. Eyes going into a bizarre twirl, I try to figure out which bizarre crisis protocol the happenings fit into and why!. The resident sheepishly drops the empty syringe into the tray when something grabs my attention. I like my liquid gold fentanyl undiluted while the protocol says 10/cc! our dude had gotten zonked on 500 Mics of the luscious crystal meth of anaesthesia.. fentanyl!
The eternal showdown in little OT notwithstanding, the consultant precisely points out my ever so subtle mistakes with heaps of advice and criticism garnishing it. We get the case done and the dude is wheeled out retaining his smile of absolute bliss.
Win some and lose some they say.. well I lost some gained ground for sure while the gallbladder dude won a trip of a lifetime, free! ‘Dilutionary’ misgivings getting less frequent, I still use the smile maker everyday in discreet amounts. Any guesses for my most FAV song…. Leisurely sung by Barry Mannilow.. I CANT SMILE WITHOUT YOU!!
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