- |||||||||| fentanyl citrate / Generic mfg.
Journal: Determination of Salt Forms of New Psychoactive Substances by Ion Chromatography (Pubmed Central) - Nov 3, 2021
The salt forms of fentanyl samples and samples of other types included base, hydrochloride and citrate. Conclusion Ion chromatography is a simple, accurate and efficient method for determining the salt form of NPS samples, which makes the qualitative and quantitative conclusions of NPS more scientific and rigorous.
- |||||||||| dexamethasone / Generic mfg.
A CASE OF PERIOPERATIVE ANAPHYLAXIS: HIGH-RISK DRUG ALLERGY TESTING IN THE INPATIENT SETTING (Hall B (1st Floor); Monitor 02) - Nov 2, 2021 - Abstract #ACAAI2021ACAAI_714;
Iodine, ChloraPrep, and tincture of benzoin were applied topically...Given the patient’s likely need for future procedures requiring anesthesia and history of severe, life-threatening reaction, the decision was made to pursue drug allergy testing. We demonstrate a systematic approach for high-risk drug allergy testing that was facilitated by admission to the ICU.
- |||||||||| cetirizine oral / Generic mfg., morphine sulphate / Generic mfg.
DIRECT PROVOCATION TESTING TO MORPHINE IN A PATIENT WITH SEVERE ALLERGIC SYMPTOMS TO OPIOIDS (Hall B (1st Floor); Monitor 01) - Nov 2, 2021 - Abstract #ACAAI2021ACAAI_702;
She tolerated fentanyl and tapentadol...Cetirizine/famotidine pre-treatment prevented distressing allergic symptoms from direct mast cell release. We review the clinical differences and diagnostic approaches to distinguish between IgE-mediated vs. non-IgE-mediated opioid reactions.
- |||||||||| midazolam hydrochloride / Generic mfg.
A CASE OF HEREDITARY ALPHA TRYPTASEMIA PRESENTING AS PERIOPERATIVE ANAPHYLAXIS (Hall B (1st Floor); Monitor 01) - Nov 2, 2021 - Abstract #ACAAI2021ACAAI_692;
The patient was given Lidocaine, Propofol, Cefazolin, Succinylcholine, Midazolam, Rocuronium, Fentanyl, Ondansetron, Fevoflurane, and Chlorohexidine pre-operatively...Symptoms resolved with IV epinephrine...The patient’s gene testing was positive for extra allelic alpha tryptase copies at TPSAB1 which is consistent with HαT. Discussion Our case shows importance of considering HαT in the differential of patients with anaphylaxis, especially in those with an elevated baseline tryptase.
- |||||||||| fentanyl citrate / Generic mfg., morphine sulphate / Generic mfg., hydromorphone hydrochloride / Generic mfg.
Journal: A Continuous Observation Workflow Time Study to Assess Intravenous Push Waste. (Pubmed Central) - Nov 2, 2021
There are financially significant costs associated with wasting both the product and the valuable time of a skilled workforce. Optimizing product size, taking special note to match product availability with common practice use, would reduce the associated financial burden on our health-systems nationwide.
- |||||||||| fentanyl citrate / Generic mfg.
Journal: A MULTIVARIATE SPATIOTEMPORAL CHANGE-POINT MODEL OF OPIOID OVERDOSE DEATHS IN OHIO. (Pubmed Central) - Nov 1, 2021
However, as the epidemic evolved, opioid overdose deaths due to fentanyl have drastically increased...By assuming the regression coefficients are a multivariate conditional autoregressive process, we capture spatial dependence within each drug type and also dependence across drug types. The proposed model allows us to not only study spatiotemporal trends in overdose death rates but also to detect county-level shifts in these trends over time for various types of opioids.
- |||||||||| fentanyl citrate / Generic mfg., hydromorphone hydrochloride / Generic mfg.
Journal: Analgosedation: The Use of Fentanyl Compared to Hydromorphone. (Pubmed Central) - Nov 1, 2021
No statistically significant differences were found in the primary endpoints studied. Patients in the hydromorphone group required more tracheostomies, restraints, and were more likely to have a higher proportion of Critical Care Pain Observation Tool (CPOT) scores > 2.
- |||||||||| fentanyl citrate / Generic mfg.
[VIRTUAL] Porphyria-induced Tetraplegia: A Case Report () - Nov 1, 2021 - Abstract #AAPMR2021AAPMR_332;
AIP may result in a severe acute motor neuropathy. Affected individuals benefit from intensive inpatient rehabilitation, pain management, and nutritional support services.
- |||||||||| fentanyl citrate / Generic mfg., morphine sulphate / Generic mfg.
Clinical, Journal, Real-world evidence: Patterns of real-world opioid prescribing in Australian general practice (2013-18). (Pubmed Central) - Oct 31, 2021
The private-medicines market is a small but growing component of opioid use in Australia and one way in which prescribers and patients can avoid access restrictions in the public market for these medicines. Although fentanyl patch prescribing declined, there is room for improvement in prescribing fentanyl patches among opioid-naïve patients, and co-prescribing of fentanyl patches with other sedatives.
- |||||||||| fentanyl citrate / Generic mfg.
Successful Neuraxial Block for a Caesarean Section in a Parturient with Goldenhar Syndrome: First Report ([VIRTUAL]) - Oct 31, 2021 - Abstract #Euroanaesthesia2021Euroanaesthesia_928;
Effective neuraxial block was achieved by a senior obstetric anaesthetist using a combined spinal and epidural technique with 1.8mls of 0.5% Heavy Marcain® and 25mcg fentanyl, supplemented with 3mg of diamorphine via epidural catheter at the end of the procedure...Both mother and baby were adequately resuscitated intraoperatively and discharged home 2 days later. Successful endotracheal intubation under general anaesthesia for elective caesarean section has been previously described in a patient with Goldenhar syndrome [1], however to our knowledge this is the first documented case of successful neuraxial obstetric anaesthesia performed in a parturient with this rare syndrome.Learning points: Obstetric patients with Goldenhar Syndrome represent an anaesthetic challenge in view of difficulty in airway management and potentially difficult neuraxial access.
- |||||||||| Soliris (eculizumab) / AstraZeneca
Paroxysmal Nocturnal Hemoglobinuria in the OR: case report ([VIRTUAL]) - Oct 31, 2021 - Abstract #Euroanaesthesia2021Euroanaesthesia_860;
We believe that the induction of anesthesia associated with the surgical stress and the low platelet count could have triggered this complication. Learning points: Managing surgical stress as a key factor.
- |||||||||| fentanyl citrate / Generic mfg., morphine sulphate / Generic mfg.
Short-term effects of opioids on size and vulnerability of murine atherosclerotic lesions ([VIRTUAL]) - Oct 31, 2021 - Abstract #Euroanaesthesia2021Euroanaesthesia_760;
Morphine leads to an increased size of atherosclerotic lesions and drives apoptosis of monocytes within the plaque, resulting in a higher plaque vulnerability. These effects are likely mediated via the Mu-opioid-receptor.
- |||||||||| ketamine / Generic mfg.
Medium-chain acyl-CoA dehydrogenase deficiency (MCADD): The importance of anesthetic approach ([VIRTUAL]) - Oct 31, 2021 - Abstract #Euroanaesthesia2021Euroanaesthesia_746;
Sevoflurane was used for maintenance and sugammadex 50mg was administered for complete reversal of the block...Althout not contraindicated, anesthesiologist should consider risk:benefit of agents such as volatile anesthetics, propofol and neuromuscular blocking agents, because these patients may present hypotonia and impaired hepatic metabolism with prolonged effect of many drugs and increased risk of propofol infusion syndrome. In case of use, adequate neuromuscular blocking monitorization should also be applied.
- |||||||||| Bridion (sugammadex) / Merck (MSD)
Anaesthetic Management in a Patient with antiIgLON5 disease ([VIRTUAL]) - Oct 31, 2021 - Abstract #Euroanaesthesia2021Euroanaesthesia_695;
General anesthesia (GA) was induced using fentanyl, lidocaine, propofol, and rocuronium...Neuromuscular blockade was reverted with sugammadex...Disease follow up is necessary. In order to avoid in extremis ventilatory support, tracheostomy should be considered.
- |||||||||| midazolam hydrochloride / Generic mfg.
Anaesthesia management of De Barsy Syndrome in a series of interventions: case report ([VIRTUAL]) - Oct 31, 2021 - Abstract #Euroanaesthesia2021Euroanaesthesia_669;
Maintenance with sevoflurane...Muscle relaxation was provided by rocuronium 0.6mg/kg...However, the microphephaly malformations suggest caution with regard to airway manipulation. Learning points: There is no single way to cope with the patient with a rare disease and initial and backup strategies should be considered to ensure safe induction of anaesthesia and correct airway control.
- |||||||||| fentanyl citrate / Generic mfg.
Surgical removal of a knotted epidural catheter by a neurosurgeon - A rare complication ([VIRTUAL]) - Oct 31, 2021 - Abstract #Euroanaesthesia2021Euroanaesthesia_646;
Teleflex Arrow Flexi Tip Plus® catheter inserted through a Tuohy needle initially 20 cm without resistance, needle removed and catheter withdrawn 11 cm at skin, after bolus test dose, Bupivacaine 0.1% in fentanyl 2 mcg/ml infusion commenced as per hospital policy...There is no universally method to remove entangled epidural catheters. This abstract endeavours to raise awareness, hence necessitating importance of establishing a universal guideline.
- |||||||||| ketorolac / Generic mfg.
Does emergent arterial bypass surgery hinder regional analgesia? (Channel 1 - ePosters [VIRTUAL]) - Oct 31, 2021 - Abstract #Euroanaesthesia2021Euroanaesthesia_618;
ASA standard monitoring was ensured and rapid sequence induction of general anaesthesia (GA) performed with fentanyl (2mcg/kg), propofol (2,5mg/kg) and rocuronium (1,2mg/kg)...GA was maintained with Sevoflurane in Air/O2 mixture...Postoperatively, Acute Care Unit noticed adequate analgesia (VAS 0 at rest and mobilization), achieved with perineural ropivacaine 0,2% (20mg q4h), paracetamol (1000mg q6h), ketorolac (30mg q12h, 48 hours) and tramadol (100mg q8h), not requiring SOS medication...The continuous AC block, as part of a multimodal analgesia, permitted adequate pain control without compromising PO anticoagulation or ability to ambulate. Thus, considering its simplicity and safety, we believe that this analgesic option can be replicated, formulating a valid protocol for this procedure.
- |||||||||| fentanyl citrate / Generic mfg.
BRILMA and PEC blocks as main anesthetic technique for breast cancer surgery in a high-risk patient (Channel 1 - ePosters [VIRTUAL]) - Oct 31, 2021 - Abstract #Euroanaesthesia2021Euroanaesthesia_616;
The patient is ASA 4, with aortic coronary bypass 3 months ago,EF 30%,COPD,DM type 2 and chronic renal failure.After placing of basic monitoring and invasive arterial monitoring, 1mg of midasolam and 50 mcg fentanyl were given.PEC block was applied with10 ml.bupivacaine 0.5% and 10 ml Lidocaine 2% was given.The BRILMA block was applied with 10 ml bupivacaine 0.5% and 10 ml lidocaine 2%.The operation started 30 minutes after the application of the blocks.The patient had no pain, with spontaneous breathing and was hemodynamically stable.In the postoperative period the patient had no pain in the first 24 hours The use of peripheral nerve blocks in breast surgery provides good analgesia during surgery and postoperatively, significantly reduces the occurrence of chronic postoperative pain. Especially important is their use as the main anesthesia technique in patients with comorbidities, thus avoiding general anesthesia and its related complications.PEC block is an interfacial block, the local anesthetic is applied between the fascia of pectoralis minor and pectoralis major muscle where the medial and lateral branches of the pectoral nerves are located.BRILMA block is an interfacial block, the local anesthetic is applied between m.Serarus anterior and mm.Intercostales externi where the intercostal nerves of T2-T8 are located.2 Learning points:The combination of these two blocks in patient with high risk (ASA 4) provides excellent perioperative analgesia, haemodynamic stability, as well as general anesthesia and related complications are avoided.
- |||||||||| fentanyl citrate / Generic mfg., ropivacaine / Generic mfg., dexmedetomidine / Generic mfg.
Anaesthetic approach of a patient with Myasthenia Gravis and polytrauma undergoing spinopelvic reduction and fixation ([VIRTUAL]) - Oct 31, 2021 - Abstract #Euroanaesthesia2021Euroanaesthesia_607;
Ropivacaine 0,75% was administered epidurally as needed during surgery (twice, 5 ml each)...Discussion and learning points: Regional anaesthetic strategies are useful alternatives for spinopelvic surgery in patients with MG and important pulmonary impairment, namely thoracic trauma, who are at substantial risk for postoperative complications, avoiding further respiratory compromise in these patients. Amide local anesthetics are preferred as esters are metabolized by pseudocolinesterases, which can be problematic in patients taking anticholinesterases.
- |||||||||| fentanyl citrate / Generic mfg., sevoflurane / Generic mfg., ropivacaine / Generic mfg.
Passive leg rising test predicts fluid responsiveness during high thoracic epidural anesthesia after offpump coronary surgery ([VIRTUAL]) - Oct 31, 2021 - Abstract #Euroanaesthesia2021Euroanaesthesia_606;
An epidural catheter was inserted at Th2-5 level with administration of 0,5% ropivacaine 1 mg/kg before surgery and continuous infusion of ropivacaine 0.2% and fentanyl 2 µg/mL at a rate of 3-8 mL/h postoperatively... During HTEA after OPCAB, the PLR can be used for prediction of fluid responsiveness and for goal-directed fluid therapy.
- |||||||||| dexamethasone / Generic mfg.
Perioperative anesthetic considerations for Fabry disease during emergency surgery (Channel 1 - ePosters [VIRTUAL]) - Oct 31, 2021 - Abstract #Euroanaesthesia2021Euroanaesthesia_579;
Monitored neuromuscular blockade was reversed with sugammadex...Pain was managed with paracetamol, metamizole and morphine...Learning points:The main problem with Fabry disease comes with renal and cardiac organic impairment. During perioperative care close monitoring should be done so a correct systemic perfusion is guaranteed and no organ dysfunction appears, particularly with special reference to lung, heart, brain and kidneys.
- |||||||||| dexmedetomidine / Generic mfg.
Dexmedetomidine as a component of anesthesiological support of laparoscopic abdominal surgery. (Channel 1 - ePosters [VIRTUAL]) - Oct 31, 2021 - Abstract #Euroanaesthesia2021Euroanaesthesia_575;
Conclusion(s):This research demonstrated that dexmedetomidine is an effective and safe drug. The inclusion of dexmedetomidine in the scheme of general combined anesthesia during laparoscopic abdominal surgery can reduce the total number of opioids and their complications in the intra- and postoperative period.
- |||||||||| ketamine / Generic mfg., dexketoprofen trometamol / Generic mfg.
Co-analgesics and opioid-sparing effect in parathyroid surgery (Channel 1 - ePosters [VIRTUAL]) - Oct 31, 2021 - Abstract #Euroanaesthesia2021Euroanaesthesia_562;
Ketamine 25 mg IV was used for induction anaesthesia in these groups...Desaturation (SpO2 below 92%) due to residual sedation and the effect of myorelaxants was observed in 39 (47.5%) and 12 (46,1%) patients in STI and STI-BCSPB during the first 30 min post-op compared to 2 cases (12.5%) in PLM-BCSPB (both STI groups were DS vs PLM-BCSPB, chi-square test). The dose of intra-op fentanyl was 334.3±56.8, 261.5±86.9 209.3±46.1 mcg in STI, STI-BCSPB and PLM-BCSPB respectively, (DS for PLM-BCSPB vs other groups, DS between STI groups) Conclusion(s): Combine Methods GA with BCSPB have some benefits vs mono GA. Co-analgesics afford to achieve an opioid-sparing effect
- |||||||||| ketamine / Generic mfg., dexketoprofen trometamol / Generic mfg.
Opiod-free anesthesia guided by Nol® monitor in bariatric surgery. Reduction of postoperative pain and PONV ([VIRTUAL]) - Oct 31, 2021 - Abstract #Euroanaesthesia2021Euroanaesthesia_540;
Pre incision, ketamine 40mg, dexketoprofen 50mg were administered and infiltration of laparoscopy ports with lidocaine 1%...At the end of surgery Paracetamol 1g, metamizole 2g and infiltration of laparoscopy ports with ropivacaine 2% and 400mg sugammadex were administered...During the procedure and postoperative no complications appeared and no rescue of morphine required...Our Results are a lower incidence of postoperative pain (with less need for postoperative opioid rescue and lower EVA scores) as well as less nausea and vomiting, and a high perceived quality of care by patients compared to standard practice using fentanyl and remifentanil. OFA protocols require management of multiple drugs and the use and validation of nociception monitors is necessary to anesthesiologists to optimal management.
- |||||||||| ketamine / Generic mfg.
Comparison of analgesic efficacy of varieties of multimodal anesthesia in renal laparoscopic surgery ([VIRTUAL]) - Oct 31, 2021 - Abstract #Euroanaesthesia2021Euroanaesthesia_534;
OFA protocols require management of multiple drugs and the use and validation of nociception monitors is necessary to anesthesiologists to optimal management. Maintaining of anesthesia: sevoflurane (MAC - 1.44 ± 0.25 vol.%)...In group 2, MMLO general anesthesia was used, using fentanyl 1.76 ± 1.2 μg/kg/h and i/v lidocaine 1.5 mg/kg/h and sub-anesthetic doses of ketamine...The use of dexmedetomidine in MMLO general anesthesia provides more complete analgesive protection and reduces the stress Response.
- |||||||||| midazolam hydrochloride / Generic mfg.
A novel awake mouse urodynamic model including external urethral sphincter electromyography reveals effects of anaesthetics on bladder function ([VIRTUAL]) - Oct 31, 2021 - Abstract #Euroanaesthesia2021Euroanaesthesia_510;
Maintaining of anesthesia: sevoflurane (MAC - 1.44 ± 0.25 vol.%)...In group 2, MMLO general anesthesia was used, using fentanyl 1.76 ± 1.2 μg/kg/h and i/v lidocaine 1.5 mg/kg/h and sub-anesthetic doses of ketamine...The use of dexmedetomidine in MMLO general anesthesia provides more complete analgesive protection and reduces the stress Response. Anaesthetics severely interfere with physiological bladder function: Fentanyl and hydromorphone disrupted the voiding phase evidenced by the reduced coordination of sphincter activity with detrusor contraction, while voiding under midazolam was achieved by sphincter relaxation only.
- |||||||||| fentanyl citrate / Generic mfg.
Clinical, Journal: Patient-Specific Sedation Management via Deep Reinforcement Learning. (Pubmed Central) - Oct 31, 2021
We assessed our method's ability to jointly learn an optimal personalized policy for propofol and fentanyl, which are among commonly prescribed sedative-hypnotics for intensive care unit sedation...The RL agent was 8% better at managing sedation and 26% better at managing mean arterial compared to the clinicians' policy; a two-sample t-test validated that these performance improvements were statistically significant (p < 0.05). The results validate that our model had better performance in maintaining control variables within their target range, thereby jointly maintaining patients' health conditions and managing their sedation.
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