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It is commonly seen in normal children but may be associated with some CHD such as Ebstein anomaly

I am not willing to operate on a patient in this category until repletion is confirmed

Believed to enhance the euphoria & analgesia produced by fentanyl, and because xylazine has a longer half life than fentanyl, it reduces the frequency of opioid injections when it is present as an adulterant (Gupta et al, 2023)

Wei X, Hou Y, Long M, et al (2022a) Molecular mechanisms underlying the role of hypoxia-inducible factor-1 in metabolic reprogramming in renal fibrosis

The typical journey looks like this: Weeks 1-4: The adjustment phase (most challenging) Weeks 4-8: Significant improvement Month 3+: Most people feel comfortable and confident But dont suffer in silence

But what happens when the blockade is lifted