Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Carfentanil is a synthetic fentanyl analogue approved for veterinary use. It is a mu-opioid receptor agonist with an estimated analgesic potency approximately 10,000 times that of morphine and 20-30 times that of fentanyl, based on animal studies. Since 2016, an increasing number of reports describe detection of carfentanil in the illicit drug supply. ⋯ Exposed individuals exhibit features of an opioid toxidrome and respond to opioid antagonists such as naloxone, although empiric dose requirements are unknown and very high doses may be required. Rare reports of suspected accidental poisoning of first responders have not been analytically confirmed and are unlikely to represent true poisoning. General occupational hygiene measures, including regular decontamination with soap and water, basic personal protective equipment (nitrile gloves, N95 mask, and eye goggles), and ready access to naloxone are generally sufficient in most circumstances.
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Editorial Comment
Intraoperative dexmedetomidine to prevent postoperative delirium: in search of the magic bullet.
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Abstract
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Comment Letter
Comment on "Encouraging a bare minimum while striving for the gold standard: a response to the updated WHO-WFSA guidelines".
Abstract
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Randomized Controlled Trial
Intraoperative use of dexmedetomidine for the prevention of emergence agitation and postoperative delirium in thoracic surgery: a randomized-controlled trial.
We investigated whether preventive use of dexmedetomidine during surgery was effective for reducing emergence agitation and postoperative delirium. ⋯ Intraoperative dexmedetomidine reduced emergence agitation but not postoperative delirium in patients undergoing thoracic surgery. Dexmedetomidine seemed to affect emergence agitation through catecholamines, but not through an anti-inflammatory action. Trial registration Clinical Research Information Service (KCT 0001877); registered 7 April, 2016.