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Preclinical, Journal: Ultra-High-Performance Liquid Chromatography-Tandem Mass Spectrometry Assay for Quantifying Fentanyl and 22 Analogs and Metabolites in Whole Blood, Urine, and Hair. (Pubmed Central) - Apr 20, 2019 Average urine concentrations were 47.7 ± 39.3 and 417 ± 296 μg/L for cyclopropylfentanyl and cyclopropyl norfentanyl, respectively (n = 11), 995 ± 908 μg/L for methoxyacetylfentanyl, (n = 3), 1,874 ± 1,710 and 6,582 ± 3,252 μg/L for acetylfentanyl and acetyl norfentanyl, respectively (n = 5), 146 ± 318 and 300 ± 710 μg/L for fentanyl (n = 5) and norfentanyl (n = 6), respectively, 84.0 and 23.0 μg/L for furanylfentanyl and furanyl norfentanyl, respectively (n = 1), and 50.5 ± 50.9 μg/L for 4-ANPP (n = 10). Average hair concentrations were 2,670 ± 184 and 82.1 ± 94.7 ng/g for fentanyl and norfentanyl, respectively (n = 2), and 10.8 ± 0.57 ng/g for 4-ANPP (n = 2).
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In 2004-2017, prescription opioid use in France at least doubled and oxycodone use increased particularly, associated with a non-trivial increase in opioid-related morbidity-mortality. Although giving no indication for an "opioid epidemic", these findings call for proper monitoring of opioid use.
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Retrospective data, Journal: Effect of different analgesic techniques on hemodynamic variables recorded with an esophageal Doppler monitor during ovariohysterectomy in dogs. (Pubmed Central) - Apr 19, 2019 Minute Distance, SD, MA and PV significantly decreased after OvP in fentanyl, ketamine, and control groups, but remained stable in the epidural group. Lumbosacral epidural lidocaine prevented hemodynamic depression changes caused by OvP ligation, whereas fentanyl and ketamine failed to do so.
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Journal: A preliminary study of different methods of anesthesia for painless bronchoscopy (Pubmed Central) - Apr 16, 2019 Propofol combined with sufentanil could achieve better painless effect, improve patient comfort and tolerance, and reduce intraoperative memory, but was prone to causing hypoxemia and hypotension. The decline of intraoperative SpO(2) could be corrected by establishing artificial airway, while the decrease of blood pressure could be corrected by applying vasoactive drugs, which were relatively safe.
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Clinical, Journal: Simultaneous explantation and implantation of intrathecal pumps: a case series. (Pubmed Central) - Apr 13, 2019 ...Of the 17 patients, 14 (82.4%) had baclofen pumps to treat spasticity and 3 (17.6%) had fentanyl pumps to treat chronic pain...The current standard of care for deep pump infections requires pump explantation and a course of antibiotics prior to reimplantation of the IDDD. The authors demonstrate the effectiveness of a procedure involving simultaneous explantation of an infected pump and implantation of a new pump on the contralateral side in the treatment of IDDD infections.
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Retrospective data, Journal: Propofol Sedation by Pediatric Gastroenterologists for Endoscopic Procedures: A Retrospective Analysis. (Pubmed Central) - Apr 12, 2019 ...The addition of fentanyl significantly decreased propofol dosage needed to provide optimal sedation, p < 0.001...All the procedures were successfully completed and all patients were discharged home. We conclude that our approach is safe in children as it is in adults and can be implemented for children with ASA I, II.
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Journal: Inhibition of Protein kinase A and GIRK channel reverses fentanyl-induced respiratory depression. (Pubmed Central) - Apr 11, 2019 A phosphodiesterase 4 (PDE4) inhibitor and cyclic adenosine monophosphate (cAMP) analogs did not affect fentanyl-induced respiratory depression. These findings suggest that PKA and GIRK may be involved in fentanyl-induced respiratory depression and could represent useful therapeutic targets for the treatment of fentanyl-induced ventilatory depression.
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Journal: Challenges of helicopter mountain rescue missions by human external cargo: need for physicians onsite and comprehensive training. (Pubmed Central) - Apr 11, 2019 Serratus anterior plane block may be used to reduce pain and opioid use after thoracoscopic lung surgery. As these interventions have to be performed in challenging terrain, with reduced personnel resources, and limited monitoring, our results point out the need for physicians onsite who are clinically experienced in these procedures and specially and intensively trained for the specific characteristics and challenges of HEC rescue missions.
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Methadone, fentanyl, and buprenorphine are the ideal analgesics in ESRD. However, complex pain syndrome requires multidrug analgesic regimen comprising opioids, non-opioids, and adjuvant medication, which should be individualized to the patient to achieve adequate pain control.
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Journal: Quantification of U-47700 and its metabolites in plasma by LC-MS/MS. (Pubmed Central) - Apr 9, 2019 ...NSO have gained popularity in the illicit drug market and have brought about an increase in fentanyl and its derivatives, as well as other chemically unrelated opioid agonists...Postmortem whole blood samples (n = 15) were analyzed with the validated method. U-47700, N-desmethyl-U-47700 and N,N-didesmethyl-U-47700 concentration ranges were 1.1-1367 ng/mL, 4.0-1400 ng/mL and 0.7-658 ng/mL, respectively.
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