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- fentanyl citrate / Generic mfg.
Anaphylaxis secondary to propofol in thyroidectomy with secondary total intravenous anesthesia (Exhibit Hall) - Aug 6, 2024 - Abstract #ASA2024ASA_4647;
After induction with fentanyl, propofol, and succinylcholine, she developed a rash and hypotension...This unique case underscores the importance of recognizing and managing intraoperative allergic reactions. Despite propofol's widespread use, reports of associated allergic reactions remain uncommon, presenting a new consideration for anesthesiologists.
- fentanyl citrate / Generic mfg., ketamine / Generic mfg.
The Double TAVR Haver: Symptomatic Paravalvular Leak in TAVR Patient Requiring a Valve-in-Valve TAVR (Exhibit Hall) - Aug 6, 2024 - Abstract #ASA2024ASA_4506;
TEE post ViV TAVR demonstrated mild PVL. Patient was extubated without neurologic sequalae and discharged home POD number 1.
- fentanyl citrate / Generic mfg., midazolam hydrochloride / Generic mfg.
Take My Breath Away: A Pediatric Case of Inspiration-Induced Ventricular Tachycardia (Exhibit Hall) - Aug 6, 2024 - Abstract #ASA2024ASA_4418;
Despite reproducible arrhythmia during deep inspiration, VT did not progress to VF. This rare case highlights long-term issues in adult congenital heart disease (ACHD), links between inspiration and arrhythmias, and specific challenges of monitored anesthetic care (MAC) in pediatric ablation.
- fentanyl citrate / Generic mfg., sevoflurane / Generic mfg., rocuronium / Generic mfg.
Mediastinal Impalement of a Metallic Foreign Body in a 5 Year Old Child (Exhibit Hall) - Aug 6, 2024 - Abstract #ASA2024ASA_4416;
Anesthesia was maintained with sevoflurane...The procedure was converted to VATS. Key considerations as a pediatric anesthesiologist included meticulous airway management, vigilant hemodynamic monitoring, and multiple reassessments, as happened once the object was discovered as intrathoracic.
- One Lung Ventilation in a Toddler with Severe Bronchial Compression and Air-trapping for Thoracoscopic Resection of a Large Posterior Mediastinal Mass. (Exhibit Hall) - Aug 6, 2024 - Abstract #ASA2024ASA_4377;
Left endo-bronchial blockade was our alternative back-up option. To preserve hypoxic pulmonary vasoconstriction, ketamine, dexmedetomidine, fentanyl were used to reduce sevoflurane requirements.
- fentanyl citrate / Generic mfg., rocuronium / Generic mfg.
Providing adequate Oxygenation for a Paralyzed patient during Rigid Bronchoscopy via Apneic Oxygenation (Exhibit Hall) - Aug 6, 2024 - Abstract #ASA2024ASA_4298;
An oxygen flow rate of 13 liters per minute was delivered without positive pressure ventilation.Throughout the duration of the case, oxygen saturation levels were consistently maintained at 99-100%. After the removal of the bronchoscope, mask ventilation revealed an end-tidal carbon dioxide level of 55 mmHg, and emergence was uneventful.
- fentanyl citrate / Generic mfg., midazolam hydrochloride / Generic mfg.
Acquired Pseudocholinesterase Deficiency in a Patient with Cirrhosis undergoing Diagnostic Endoscopic Gastroduodenoscopy under General Anesthesia. (Exhibit Hall) - Aug 6, 2024 - Abstract #ASA2024ASA_4285;
Management included supportive care and psychological support for awareness under paralysis. This case underscores the importance of considering pseudocholinesterase deficiency in cirrhotic patients undergoing anesthesia, highlighting the need for vigilance and cautious use of succinylcholine.
- fentanyl citrate / Generic mfg., rocuronium / Generic mfg.
Challenges in Monitoring Anesthesia Awareness During Magnetic Resonance Imaging (Exhibit Hall) - Aug 6, 2024 - Abstract #ASA2024ASA_4281;
Her immobility intensified her distress. This case highlights the challenge of monitoring anesthesia depth during MRI where bispectral monitoring falls short, and explores the need for alternative monitoring techniques or adjustments in anesthesia protocols to prevent such occurrences.
- Anesthesia Management for Anomalous Left Coronary from the Pulmonary Artery Reconstructed without Cardiac Arrest (Exhibit Hall) - Aug 6, 2024 - Abstract #ASA2024ASA_4110;
An erector spinae nerve block was administered at the end of the case. Prior to discharge, patient had a transthoracic echocardiogram, revealing an improved EF of 50%.
- fentanyl citrate / Generic mfg., ketamine / Generic mfg., hydromorphone hydrochloride / Generic mfg.
Difficult Post-Operative Pain Management of a Patient with Lower Extremity Soft Tissue Infection and Undisclosed Buprenorphine (Exhibit Hall) - Aug 6, 2024 - Abstract #ASA2024ASA_4043;
Patient had rapid and significant pain relief after placement and for the duration of the infusion. This case discusses relative contraindication of infection for regional anesthesia, withheld drug history by the patient, and poorly managed chronic pain due to poor compliance.
- Seizalam (midazolam intramuscular) / Pfizer
(Exhibit Hall) - Aug 6, 2024 - Abstract #ASA2024ASA_4028;
The need for offsite anesthesia and MRI compatible equipment presented challenges. We discuss a unique strategy for anesthetic management for a patient with MD requiring anesthesia outside of the operating room setting.
- fentanyl citrate / Generic mfg., sevoflurane / Generic mfg.
Successful Management of Tracheostomy under Surveillance of Fiberoptic Examination in a Patient with Tracheal Stent (Exhibit Hall) - Aug 6, 2024 - Abstract #ASA2024ASA_4021;
To avoid puncturing the tracheal stent, we performed fiberoptic examination through the ETT while the surgeon advanced puncture needle into the tracheal lumen. The PDT procedure was successfully completed without complications.
- dexmedetomidine / Generic mfg.
Combined General and Neuraxial Anesthetic Management with Dexmedetomidine and Bupivacaine in a patient with large bilateral apical bullae undergoing Emergency Exploratory Laparotomy for Small Bowel Obstruction (Exhibit Hall) - Aug 6, 2024 - Abstract #ASA2024ASA_4009;
The patient received a thoracic epidural intermittently bolused with 0.25% bupivacaine and a total of 10mcg of dexmedetomidine to avoid intraoperative opioid use to minimize respiratory depression. The patient did well and had adequate pain control intraoperatively and postoperatively only requiring 100mcg fentanyl intraoperatively.
- fentanyl citrate / Generic mfg., hydrocortisone / Generic mfg., rocuronium / Generic mfg.
COPD-Associated MAT Resolution Following Foreign Body Removal From Rectosigmoid (Exhibit Hall) - Aug 6, 2024 - Abstract #ASA2024ASA_4002;
Immediately following foreign body removal from the distal colon, the patient spontaneously converted to normal sinus rhythm. Management goals should prioritize surgical management over medication treatment of MAT for expedited resolution.
- fentanyl citrate / Generic mfg., remifentanil / Generic mfg., dexmedetomidine / Generic mfg.
Anesthetic Management of a Patient with Multiple Comorbid Neuromuscular Disorders (Exhibit Hall) - Aug 6, 2024 - Abstract #ASA2024ASA_3999;
Given her comorbidities and prior perioperative complications, we instead proposed to pursue conscious sedation with a bolus of remifentanil for analgesia during the brief period of painful stimulus. She tolerated the procedure well with a combination of propofol, fentanyl, and dexmedetomidine and recovered appropriately.
- fentanyl citrate / Generic mfg.
Oxygenation and Sedation of a Patient With Severe Facial Deformities (Exhibit Hall) - Aug 6, 2024 - Abstract #ASA2024ASA_3988;
Patient was sedated using midazolam, propofol, and fentanyl. Oxygenation was achieved with a Procedural Oxygen Mask secured over open cavities using Tegaderm and a nasal cannula with flow over the mouth.
- fentanyl citrate / Generic mfg.
Unusual Presentation of Anesthesia Conversion Disorder in PACU (Exhibit Hall) - Aug 6, 2024 - Abstract #ASA2024ASA_3979;
After an uneventful general anesthetic utilizing propofol and fentanyl without airway manipulation, patient arrived in PACU after 30 minutes in GI recovery...Patient demonstrated gradual return to neurologic baseline after 3 hours in PACU. Decision made to admit patient for observation.
- fentanyl citrate / Generic mfg.
Tap-dancing Toes during Parathyroidectomy secondary to Propofol infusion (Exhibit Hall) - Aug 6, 2024 - Abstract #ASA2024ASA_3918;
Monitoring with BIS value of 30 and propfol at 150 mcg/kg/min plus fentanyl. No other significant intra or postoperative events, with no intraoperative awareness.
- fentanyl citrate / Generic mfg.
Xylazine: A Rapidly Expanding Additive to Illegal Fentanyl in the Opioid Crisis Community (Exhibit Hall) - Aug 6, 2024 - Abstract #ASA2024ASA_3663;
In Philadelphia, virtually all (>90%) of the illegal drug supply is fentanyl-xylazine combined.We present here a case of fentanyl-xylazine use with life-threatening sepsis and wounds. We outline a coordinated multidisciplinary approach encompassing withdrawal treatment utilizing aggressive ?2 agonist, opioid therapies and multimodal analgesia, including regional anesthesia.
- fentanyl citrate / Generic mfg., rocuronium / Generic mfg.
Anesthesia and Mitochondrial Disease (Exhibit Hall) - Aug 6, 2024 - Abstract #ASA2024ASA_3558;
Furthermore, the patient received analgesia and TAP block. The perioperative course was uneventful, an otherwise unremarkable hospital course with discharge the following day.
- ByFavo (remimazolam) / PAION, Cosmo Pharma, Mundipharma, Pharmascience, Eagle Pharma
Mitochondrial Disease and Monitored Anesthesia Care in an ambulatory surgery setting (Exhibit Hall) - Aug 6, 2024 - Abstract #ASA2024ASA_3557;
The use of fentanyl has minimal inhibition on mitochondrial function. This combination for MAC is adequate and safe for patients with mitochondrial disease, especially in an ambulatory surgery setting.
- fentanyl citrate / Generic mfg., sevoflurane / Generic mfg., rocuronium / Generic mfg.
General Anesthesia for magnetic resonance imaging (MRI) in a patient with Heyn-Sproul-Jackson syndrome. The fifth case in the world, first in Brazil (Exhibit Hall) - Aug 6, 2024 - Abstract #ASA2024ASA_3555;
Maintenance with sevoflurane...Despite no signs of any immediate adverse effects related to the anesthesia, there was a prolonged emergence from anesthesia. Notably, there's scant literature on anesthetic management for this syndrome, emphasizing its rarity and lack of understanding.
- FONTAN PHYSIOLOGY AND AMBULATORY ANESTHESIA (Exhibit Hall) - Aug 6, 2024 - Abstract #ASA2024ASA_3552;
She was on tadalafil, lisinopril and aspirin...She received 1 liter crystalloid, NO at 20 ppm through HFNC, ketamine 75 mg, fentanyl, midazolam and paracervical block...At extubation, she had transitory desaturation that returned to baseline with reapplication of HFNC. She was discharged home later that day.
- fentanyl citrate / Generic mfg., dexamethasone / Generic mfg., dexmedetomidine / Generic mfg.
Stiff Person Syndrome: Management Using Total Intravenous Anesthesia in an Ambulatory Setting (Exhibit Hall) - Aug 6, 2024 - Abstract #ASA2024ASA_3551;
The procedure was uneventful. The patient was extubated successfully and discharged home the same day with no complications.
- fentanyl citrate / Generic mfg., midazolam hydrochloride / Generic mfg., epinephrine / Generic mfg.
Anaphylaxis Presenting as Difficulty Ventilating Through a Supraglottic Airway (Exhibit Hall) - Aug 6, 2024 - Abstract #ASA2024ASA_3541;
A diffuse skin rash was also noted, but the patient did not have significant hypertension. Patient was treated for presumed anaphylaxis to isosulfan blue with epinephrine and transferred to an outside hospital.
- | fentanyl citrate / Generic mfg.
Journal: The Mobile Overdose Response Program: A mobile, low-threshold opioid use disorder treatment model in Philadelphia. (Pubmed Central) - Aug 5, 2024
The only predictor of effective care linkage was referral to brick-and-mortar clinics staffed by mobile unit physicians. These findings support the importance of outreach beyond traditional health care settings to engage high-risk patients with OUD.
- | Journal: Anterior quadratus lumborum block for analgesia after living-donor renal transplantation: a double-blinded randomized controlled trial. (Pubmed Central) - Aug 5, 2024
P=N/A
The anterior QL block did not reduce opioid consumption in patients receiving multimodal analgesia after living-donor renal transplantation. Our findings do not support the routine administration of the anterior QL block in this surgical population.
- | fentanyl citrate / Generic mfg.
Journal: Differentiating Structurally Similar Fentanyl Analogs by Comparing Density Functional Theory (DFT) Calculations and Surface-Enhanced Raman Spectroscopy (SERS) Results. (Pubmed Central) - Aug 4, 2024
The limit of detection values for FIBF and CPrF were determined to be 0.35?ng/mL and 4.4?ng/mL, respectively, using SERS. Experimental results obtained in this project can be readily implemented in field applications and smaller laboratories, where inexpensive portable Raman spectrometers are often present and used in drug analysis.
- | ByFavo (remimazolam) / PAION, Cosmo Pharma, Mundipharma, Pharmascience, Eagle Pharma
Journal: Predicted effect-site concentrations of remimazolam for i-gel insertion: a prospective randomized controlled study. (Pubmed Central) - Aug 4, 2024
Experimental results obtained in this project can be readily implemented in field applications and smaller laboratories, where inexpensive portable Raman spectrometers are often present and used in drug analysis. An effect-site concentration of ??1.57
- | fentanyl citrate / Generic mfg.
Retrospective data, Journal: Ultrasound-guided ilioinguinal-iliohypogastric nerve block with local anesthesia and fentanyl analgesia versus local anesthesia and fentanyl analgesia prior to Shouldice inguinal hernia repair in adults: a retrospective matched-pair analysis among 100 individuals. (Pubmed Central) - Aug 3, 2024
An effect-site concentration of ??1.57 The administration of an ilioinguinal-iliohypogastric nerve block prior to primary inguinal hernia repair using a Shouldice Repair is associated with a significantly lower intraoperative fentanyl consumption compared to non-administration.
- | fentanyl citrate / Generic mfg., hydromorphone hydrochloride / Generic mfg.
Journal, Surgery: Impact of Replacing Fentanyl With Hydromorphone as the First-Line Postoperative Opioid Among Patients Undergoing Outpatient Cancer Surgery. (Pubmed Central) - Aug 3, 2024
The multidisciplinary team concluded that the increase in postoperative length of stay associated with hydromorphone was not clinically significant and the decrease waste of prefilled syringes outweighed the small potential increased risk of resurgery compared to the shorter-acting fentanyl. We will therefore use hydromorphone moving forward.
- | remifentanil / Generic mfg.
Journal, Surgery: Effect of A118G (rs1799971) single-nucleotide polymorphism of the ?-opioid receptor OPRM1 gene on intraoperative remifentanil requirements in Japanese women undergoing laparoscopic gynecological surgery. (Pubmed Central) - Aug 2, 2024
The G allele of the A118G SNP was associated with higher intraoperative remifentanil requirements and higher intraoperative BIS values but was not associated with propofol requirements. Given that remifentanil and propofol act synergistically on the BIS, these results suggest that the G allele of the A118G SNP is associated with lower effects of remifentanil in achieving adequate intraoperative analgesia and in potentiating the sedative effect of propofol on the BIS.
- | fentanyl citrate / Generic mfg.
Journal: The Association Between Sleep Disturbances and Perceived Stress in Substance Use Disorder Treatment. (Pubmed Central) - Aug 2, 2024
The findings suggest that sleep/stress associations are ubiquitous across different classes of drugs, although sleep might have more influence on stress in persons primarily using heroin/ fentanyl, and stress might have more influence on sleep in persons primarily using cocaine, relative to other substances. Interventions targeting either sleep or stress could have positive effects on SUD outcomes, but further research is needed to investigate the underlying neurobiological mechanisms and inform the development of effective interventions for sleep and stress in SUD populations.
- | fentanyl citrate / Generic mfg.
Journal: A Comparison of Subarachnoid Block Characteristics Following Co-administration of Fentanyl Premixed With Hyperbaric Bupivacaine Versus Antecedent or Succedent to Hyperbaric Bupivacaine: A Randomized Controlled Study. (Pubmed Central) - Aug 2, 2024
Data analysis was done using SPSS version 17.0 (SPSS Statistics Inc., Chicago, IL, USA). Results The mean time taken for the onset of sensory and motor blockade was least in Group D followed by Group C. Duration of sensory and motor blockade was prolonged in Group D. Patients in Group A experienced more hypotension than Groups B, C, and D. Requirement of rescue analgesia was delayed in Groups C and D. Conclusions Administering 25
- | fentanyl citrate / Generic mfg.
Journal: Para-fluorofentanyl: Coincidence or intentional? (Pubmed Central) - Aug 1, 2024
Results The mean time taken for the onset of sensory and motor blockade was least in Group D followed by Group C. Duration of sensory and motor blockade was prolonged in Group D. Patients in Group A experienced more hypotension than Groups B, C, and D. Requirement of rescue analgesia was delayed in Groups C and D. Conclusions Administering 25 No abstract available
- | ByFavo (remimazolam) / PAION, Cosmo Pharma, Mundipharma, Pharmascience, Eagle Pharma, Bridion (sugammadex) / Merck (MSD)
Journal: A case of opioid-induced rigidity requiring naloxone administration at the time of anesthesia emergence. (Pubmed Central) - Aug 1, 2024
Even as the simulated effect site concentration of fentanyl decreases during anesthesia emergence, opioid-induced rigidity may still occur. Rapid reversal of remimazolam by flumazenil might have contributed to the rigidity in this case.
- | fentanyl citrate / Generic mfg.
Journal: Understanding Clinician Knowledge, Attitudes, and Practices Relating to Nonpharmaceutical Fentanyl and Harm Reduction. (Pubmed Central) - Aug 1, 2024
While clinicians had knowledge and awareness of NPF and rated overdose prevention as highly important, utilization of harm reduction and treatment strategies was variable. This study highlights opportunities for education and system-based support to improve clinician-driven harm reduction practices for patients at risk of overdose.
- | Journal: The Emergence of Bromazolam in Jefferson County AL. A Case Series. (Pubmed Central) - Aug 1, 2024
While all manners of death were ruled as accidental, bromazolam was included in the cause of death statements in nine of the ten cases. Capturing important emerging drug trends on the death certificate is critical to help inform public health and medical colleagues for preventive measures and treatment in the continued drug epidemic.
- | fentanyl citrate / Generic mfg., methamphetamine / Generic mfg.
Journal: Fluorofentanyl and Novel Synthetic Opioids in Accidental Overdose Deaths. (Pubmed Central) - Aug 1, 2024
NSO, mainly, fluorofentanyl were observed in matched drug paraphernalia. This report documents the migration of fluorofentanyl to the West Coast, specifically California.
- | ropivacaine / Generic mfg.
Journal: Programmed Intermittent Epidural Boluses of 0.1% Ropivacaine Versus 0.2% Ropivacaine for the Maintenance of Epidural Analgesia in Labor. (Pubmed Central) - Aug 1, 2024
The aim of this study was to evaluate the optimum ropivacaine concentration between two different regimens (0.1% or 0.2% both with fentanyl 2 ?g/ml) that can provide satisfactory analgesia with the minimum degree of motor blockade, using PIEBs. Concerning the 0,2% group, diastolic blood pressure and APGAR scores were lower alongside with a lower satisfactory extrusion stage observed by
- | fentanyl citrate / Generic mfg.
Journal: Xylazine is an agonist at kappa opioid receptors and exhibits sex-specific responses to opioid antagonism. (Pubmed Central) - Aug 1, 2024
Xylazine is in the unregulated drug supply at increasing rates, usually combined with fentanyl, necessitating understanding of its pharmacology...Finally, we demonstrate surprising effects of xylazine to kappa opioid antagonism, which are relevant for public health considerations. These data address an ongoing health crisis and will help inform critical policy and healthcare decisions.
- | fentanyl citrate / Generic mfg.
Journal: Initiation of Buprenorphine Treatment of Opioid Use Disorder in Pediatric Emergency Departments. (Pubmed Central) - Jul 31, 2024
Pediatric emergency departments (EDs) in the United States are facing a rise in the number of children and adolescents who present with opioid use disorder (OUD), often driven by illicitly manufactured fentanyl...Both patients were successfully started on buprenorphine/naloxone in the pediatric ED before transitioning to an outpatient addiction clinic for continued treatment. The case series demonstrates the feasibility of ED-based buprenorphine initiation for adolescents, an important and timely intervention for adolescents with OUD.
- | fentanyl citrate / Generic mfg.
Journal: Opioid-stimulant trends in overdose toxicology by race, ethnicity, & gender: An analysis in Delaware, 2013-2019. (Pubmed Central) - Jul 31, 2024
While combined opioid-cocaine toxicology grew among Black and Hispanic Delawareans, White males continue to report the highest rates overall. These findings depart from historical patterns and may challenge existing opioid epidemic policies.
- | fentanyl citrate / Generic mfg., methadone / Generic mfg.
Retrospective data, Journal: Piloting a Hospital-Based Rapid Methadone Initiation Protocol for Fentanyl. (Pubmed Central) - Jul 31, 2024
Patients up-titrated their methadone doses quicker than with traditional induction methods, and there were no serious adverse events. Appropriate patient selection may be important to avoid harms.
- | fentanyl citrate / Generic mfg., methamphetamine / Generic mfg.
Journal: Estimating the Prevalence of Using Suspected Counterfeit Medications in the General Population. (Pubmed Central) - Jul 31, 2024
These data show the scale of the issue in relation to other well established drug use data points in the US. System-level methods, such as drug scanning software, should be implemented to reduce the likelihood that counterfeit drugs end up in the hands of individuals.
- || fentanyl citrate / Generic mfg.
Review, Journal: Fentanyl Test Strips for Harm Reduction: A Scoping Review. (Pubmed Central) - Jul 31, 2024
Differences in FTS efficacy likely exist between people who use opioids and nonopioid drugs, with additional investigation strongly needed. As drug testing with point-of-care immunoassays is embraced for nonfentanyl contaminants such as xylazine and benzodiazepines, increased investment in examining overdose prevention is necessary.
- || fentanyl citrate / Generic mfg.
Review, Journal: High-Dose Buprenorphine Initiation: A Scoping Review. (Pubmed Central) - Jul 31, 2024
However, the current literature about high-dose buprenorphine is limited by inconsistent side effect reporting, limited power to detect rare safety events such as respiratory depression, limited follow-up data, and few comparison studies between high-dose and regular initiation protocols. Further prospective data are needed to evaluate the safety and effectiveness of this initiation strategy.
- || fentanyl citrate / Generic mfg., morphine sulphate / Generic mfg.
Review, Journal: Opioid-Based Haptens: Development of Immunotherapy. (Pubmed Central) - Jul 31, 2024
Immunotherapy for opioid addiction includes the induction of anti-drug vaccines which are composed of a hapten, a carrier protein, and adjuvants. In this review we survey the design of opioid haptens, the development of the opioid radioimmunoassay, and the results of immunotherapy for OUDs.
- | fentanyl citrate / Generic mfg., dexmedetomidine / Generic mfg.
Journal: Comparison of analgesia nociception index, surgical pleth index and hemodynamic parameters between patients receiving fentanyl versus dexmedetomidine analgesia for supratentorial craniotomy - an open label active-controlled randomized trial. (Pubmed Central) - Jul 31, 2024
There was no difference between the groups with respect to any of the variables at skin incision and craniotomy. ANI during use of dexmedetomidine and SPI while using fentanyl, might be the better choices as intraoperative nociception monitors.
- | morphine sulphate / Generic mfg.
Journal: Comparison of intrathecal morphine versus erector spinae block for postoperative analgesia in patients with end-stage kidney disease undergoing kidney transplantation: A randomised clinical study. (Pubmed Central) - Jul 31, 2024
In Group M, there was significantly more nausea, vomiting and pruritus (P = 0.001). ITM provides long-lasting postoperative analgesia at the cost of higher side effects than ESP block.