Midazolam-Fentanyl Sedation

To the Editor.— Myron Yaster et al are to be congratulated for their candid discussion of the near fatal experience with midazolam-fentanyl described in their article.1 By 1988 at least 88 deaths had been reported to the Food and Drug Administration under similar circumstances; and these represent only the tip of the iceburg because most occurrences are not reported. Yaster has warned quite correctly that all sedatives become general anesthetics if enough drug is given. Fentanyl, as does any opiate, prolongs and potentiates in unpredictable fashion the effects of midazolam (Versed).