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Human exposures to immobilising agents: results of an online survey
  1. A. Haymerle, CandMedVet1,
  2. Å. Fahlman, DrMedVet, VetMedLic PhD2 and
  3. C. Walzer, DrMedVet1
  1. 1 Research Institute of Wildlife Ecology, University of Veterinary Medicine, A-1160 Vienna, Austria
  2. 2 Department of Clinical Sciences, Faculty of Veterinary Medicine and Animal Science, Swedish University of Agricultural Sciences, PO Box 7054, SE-750 07 Uppsala, Sweden
  1. E-mail for correspondence: agneshaymerle{at}hotmail.com

Abstract

Cases of human exposure to veterinary injectable anaesthetics were reviewed following a literature search and completion of an online questionnaire in an attempt to provide an objective approach to the problem. The modified Glasgow Coma Scale was used to rank cases according to their severity. From the cases examined, results showed that intoxication with potent opioids, such as etorphine, carfentanil and thiafentanil, need to be treated with antagonists such as naloxone, nalmefene or naltrexone, and not with antagonists with agonistic properties, such as diprenorphine. With regard to the α2-agonists xylazine, detomidine, medetomidine and romifidine, no antagonist is currently accredited for human use. Atipamezole, a specific α2-antagonist, is widely used in veterinary medicine and has been used experimentally to reverse dexmetomidine in a study in human medicine. The high concentrations of α2-agonists being used in zoo and wildlife medicine warrant the accreditation of atipamezole for use in cases of human exposure. Knowledge and availability of the appropriate antagonist are essential in cases of human intoxication with injectable anaesthetics. Preventive measures, such as wearing gloves and eye protection, need to be used more regularly to reduce the risk of exposure.

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