• Pediatrics · Jul 2014

    Case Reports

    Treatment of tetralogy of Fallot hypoxic spell with intranasal fentanyl.

    • Daniel S Tsze, Yaffa M Vitberg, Joel Berezow, Thomas J Starc, and Peter S Dayan.
    • Department of Pediatrics, Columbia University College of Physicians and Surgeons, New York, New York dst2141@columbia.edu.
    • Pediatrics. 2014 Jul 1;134(1):e266-9.

    AbstractWe present the case of a 3-month-old girl who had unrepaired Tetralogy of Fallot who presented to the emergency department with an acute hypoxic episode. The patient was hyperpneic and cyanotic, with an initial oxygen saturation of 56%. She did not respond to knee-to-chest positioning. A single dose of intranasal fentanyl was administered with subsequent resolution of her symptoms and improvement of her oxygen saturation to 78% within 10 minutes. To our knowledge, this is the first report of the successful treatment of a hypoxic episode of Tetralogy of Fallot using intranasal fentanyl.Copyright © 2014 by the American Academy of Pediatrics.

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