Please confirm that an ethics committee approval has been applied for or granted: Not relevant (see information at the bottom of this page)
Application for ESRA Abstract Prizes: I apply as an Anesthesiologist (Aged 35 years old or less)
Background and Aims There has been dramatic rise in polysubstance abuse including utilization of synthetic compounds. A new combined agent known colloquially as ‘Fetty Tranq’ is an emerging threat. Xylazine, a non-opioid veterinary tranquilizer with direct alpha-2 adrenergic receptor agonism, is being combined with street fentanyl to extend effects and enhance euphoria. Through alpha-adrenergic effects, xylazine produces local vasoconstriction leading to characteristic and progressive wound presentation. Epidemiologic studies demonstrate geographical predominance of this toxic combination in the Northeastern United States, particularly in the city of Philadelphia. The latest health update released by the Philadelphia Department of Public Health in December of 2022 reported detection of xylazine in 90% of street opioid samples.
Methods 41-year-old male with several year history of intravenous drug use presented with several islands of necrotic wounds on bilateral lower extremities. Addiction medicine consulted for withdrawal and pain management in setting of active substance use. Patient taken to OR by plastic surgery for excisional debridement of wounds. Right popliteal-sciatic and left adductor canal catheters placed for postoperative pain management by RAAPM service.
Results Important to recognize, identify and transfer to appropriate level and range of care. This is not a ‘Narcan-resistant opioid’, but rather a combination of two chemicals with physical and psychological consequences.
Conclusions After one-month follow-up post grafting to bilateral lower extremities, patient continues local wound care with non-adherent dressings and minimal pain. Purpose of this case report is to exemplify team-based approach and global view of treatment for patient in need of withdrawal treatment, surgical wound care and multimodal analgesia.
Statistics from Altmetric.com
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.