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Previous studies have demonstrated that all four substances (snus, cigarette smoke, alcohol, and cannabis) perturb the oral microbiome and consistently enrich pathways for xenobiotic metabolism 58,59

It seems like the key points are to make the ophthalmologists aware of the potential danger of heavy sedation and non-fasting and to make local guidelines that take into account the type of surgery, type of local and regional anaesthesia, the need for sedation and the possibility of having to convert a failed regional anaesthetic to a general one

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