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Fentanyl Test Strips Are Effective In Reducing Overdose Risk

Young adults who use drugs find fentanyl test strips useful, residue testing more convenient and testing at home more private, a Brown study found. Fentanyl is a synthetic opioid so potent that a miniscule amount equivalent to several grains of salt can cause a fatal overdose. Yet it's difficult for people who use drugs to detect, which presents a major public health hazard given how commonly fentanyl is used to lace heroin or cocaine. The new findings were published on in Harm Reduction Journal.

Opioid Overdose: FDA Moves to Fast-Track OTC Naloxone

The US Food and Drug Administration (FDA) announced "unprecedented" steps to support companies in developing over-the-counter (OTC) naloxone to help reduce opioid overdose deaths."With the number of overdose deaths involving prescription and illicit opioids more than doubling over the last 7 years to nearly 48,000 in 2017, it's critical that we continue to address this tragedy from all fronts," FDA Commissioner Scott Gottlieb, MD, said in a statement.

ERCP Patients: General Endotracheal Anesthesia Is Preferred

Patients at higher risk for sedation-related adverse events could benefit from undergoing endoscopic retrograde cholangiopancreatography with general endotracheal anesthesia rather than monitored anesthesia, according to research published in Gastrointestinal Endoscopy.

Vladimir M. Kushnir wrote that although the ASGE recommends anesthesia-administered sedation to be considered in all complex endoscopic procedures, there is no current standard of care regarding the type of anesthesia and airway management during ERCP.

10 Times More Of Lignocaine Dose Given Accidentally At SGH

An elderly woman was accidentally given 10 times her prescribed dose of anaesthetic when undergoing treatment for a range of ailments at the Singapore General Hospital (SGH) two years ago, a coroner's inquiry revealed. Madam Chow Fong Heng was pronounced dead two days later in an SGH ward, but a forensic pathologist certified the cause of her death as multi-organ failure and blood poisoning, with end-stage renal failure as a contributing factor. Severe overdoses of the anaesthetic called lignocaine can result in seizures, morbidity and mortality, a medical officer from SGH's National Heart Centre testified.

Prevention of Chronic Postsurgical Pain

Systemic lidocaine may modulate several of the pathophysiological processes linked to CPSP. This systematic review aims to identify and synthesize the evidence linking lidocaine infusions and CPSP. Chronic postsurgical pain incidence was consistent with existing epidemiological data. Current limited clinical trial data and biological plausibility support lidocaine infusions use to reduce the development of CPSP without full assurances as to its safety.

Neostigmine and Atropine: In Management Of PDPH

Postdural puncture headache (PDPH) is a complication of spinal anesthesia or lumbar puncture and is an unpleasant experience for the patient as well as the anesthetist. It is thought to result from meningeal traction related to low cerebrospinal fluid (CSF) pressure or cerebral vasodilation as an indirect effect of decreased CSF pressure. A clinical experience with neostigmine prompted the comparison of the efficacy of neostigmine and conservative management for the treatment of PDPH.

Intranasal Ketamine vs. Fentanyl at Relieving Acute Pain in Kids

Intranasal ketamine is noninferior to intranasal fentanyl at relieving pain in children with acute extremity injuries, a new study found.  "We were happy to discover similar results to the two other prior pediatric trials and pleasantly surprised to see how similar the rates of rescue analgesia were to those studies," Dr. Theresa M. Frey of Cincinnati Children's Hospital Medical Center reported. 

Ondansetron: An Effective Alternative to Decrease the Incidence of Postspinal Hypotension

One of the important and predicted physiological effects of spinal anesthesia is hypotension. A range of strategies including mechanical interventions, intravenous fluids and vasoconstrictor drugs have been used to minimize or prevent spinal anesthesia-induced hypotension.

Observational studies suggest that ondansetron reduces the incidence of post-spinal hypotension (PSH) and support the use of combined fluid preloading and vasoconstrictors for this purpose (but with limited doses) to avoid side effects as fluid overload and tachycardia respectively.