A&A practice
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The delivery of drugs from the manufacturer to the hospital is a complex process. Despite numerous safeguards, lapses may occur, creating the potential for patient harm. ⋯ No patients received the anesthetic. This report describes how such an error occurred, explains the differences between veterinary and human medications, and emphasizes the importance of vigilance in the drug supply chain to prevent patient harm.
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Opioid-induced catatonia is underrecognized and poorly understood in the literature. An 81-year-old woman with chronic kidney disease stage III taking sertraline underwent surgery with general anesthesia, receiving fentanyl, hydromorphone, and ketamine. ⋯ Differential diagnoses and etiologies discussed reveal a possible multifactorial catatonia mechanism involving opioids, ketamine, and serotonin. Anesthesiologists should consider these potential interactions when using opioids for management of vulnerable patients.