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Fatal overdose after ingestion of a transdermal fentanyl patch in two non-human primates.

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Article
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Deschamps, Jack-Yves ; Gaulier, J.M. ; Podevin, G. ; Cherel, Yan ; Walker, L. ; Ferry, N. ; Roux. F.A.

VETERINARY ANAESTHESIA AND ANALGESIA

Emergency and Critical Care Unit, LUNAM University, ONIRIS, Nantes-Atlantic College of Veterinary Medicine, Food Science and Engineering - La Chantrerie, Nantes, France Department of Pharmacology and Toxicology, University Hospital, Limoges, France Department of Pediatric Surgery, University Hospital, Angers, France Department of Pathology, LUNAM University, Oniris, Nantes-Atlantic College of Veterinary Medicine, Food Science and Engineering - La Chantrerie, Nantes, France INSERM UMR S948, Biothérapies hépatiques, CHU Hotel Dieu, Nantes Cedex, France Emergency and Critical Care Unit, Alfort School of Veterinary Medicine, Maisons-Alfort Cedex, France.

2012

Article

Abstract : Case history and presentation : Two non-human primates (Macaca fascicularis), weight 3.5 kg, enrolled in an experimental protocol received a 25 microgram hour(-1) transdermal fentanyl patch for postoperative analgesia. The following day both animals were clinically normal, but after a new induction of anaesthesia with ketamine, they developed severe and prolonged respiratory distress, profound coma and myosis. Management and follow-up Attempted reversal with naloxone was ineffective. After several hours of ventilation, both primates eventually died, 7 and 15 hours after ketamine injection, respectively. In both cases, the patch was discovered in the animal's cheek pouch. Subsequent fentanyl serum concentration measurements (8.29 and 14.80 microgram L(-1) ) confirmed fentanyl overdose. Conclusions This report of two fatal intoxications in non-human primates secondary to ingestion of a transdermal fentanyl patch demonstrates that this method of analgesia is inappropriate for non-human primates, because of their tendency to chew almost anything they can reach.
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