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Naloxone infusion and post-hysterectomy morphine consumption: a double-blind, placebo-controlled study.
Acta Anaesthesiol Scand. 2012 Nov; 56(10):1241-9.AA

Abstract

BACKGROUND

The evidence that an infusion of a low dose of naloxone reduces post-operative pain and opioid analgesic consumption is somewhat conflicting. Thus, the aim of the present study was to investigate the effect of an ultra-low dose of naloxone on patient-controlled morphine analgesia.

METHODS

Ninety patients, 35-55 years old, scheduled for total abdominal hysterectomy, were enrolled in this prospective, randomized, double-blind and placebo-controlled study. Post-operatively, they received either saline (n = 45) or naloxone (n = 45) for 24 h. A standard general anesthesia was administered in both groups. In the recovery room, patients received morphine by a patient-controlled analgesia device. An ultra-low dose of naloxone was infused intravenously at 0.25 μg/kg/h for 24 h in the intervention group. Saline was infused in the control group. Following the surgery, morphine consumption, numeric rating score for pain intensity, nausea and vomiting, pruritus, and requests for antiemetic were recorded at baseline, 30 min, 1, 4, 8,16, 20, and 24 h following their discharge from recovery.

RESULTS

Naloxone reduced morphine consumption over the first 24 post-operative hours significantly compared with the controls (saline) {19.5 [standard deviation (SD) 3.4] mg vs. 27.5 [SD 5.9] mg; P < 0.001}. The incidence and severity of nausea and vomiting was significantly reduced in the naloxone group. The incidence of pruritus and the pain scores at rest and activity were not significantly different.

CONCLUSION

Following hysterectomy, an ultra-low dose of naloxone infusion proved to reduce morphine consumption as well as the incidence and severity of opioid-induced nausea and vomiting.

Authors+Show Affiliations

Department of Anesthesiology, Pain and Critical Care, Dr Ali Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. movafegh@tums.ac.irNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

22946762

Citation

Movafegh, A, et al. "Naloxone Infusion and Post-hysterectomy Morphine Consumption: a Double-blind, Placebo-controlled Study." Acta Anaesthesiologica Scandinavica, vol. 56, no. 10, 2012, pp. 1241-9.
Movafegh A, Shoeibi G, Ansari M, et al. Naloxone infusion and post-hysterectomy morphine consumption: a double-blind, placebo-controlled study. Acta Anaesthesiol Scand. 2012;56(10):1241-9.
Movafegh, A., Shoeibi, G., Ansari, M., Sadeghi, M., Azimaraghi, O., & Aghajani, Y. (2012). Naloxone infusion and post-hysterectomy morphine consumption: a double-blind, placebo-controlled study. Acta Anaesthesiologica Scandinavica, 56(10), 1241-9. https://doi.org/10.1111/j.1399-6576.2012.02764.x
Movafegh A, et al. Naloxone Infusion and Post-hysterectomy Morphine Consumption: a Double-blind, Placebo-controlled Study. Acta Anaesthesiol Scand. 2012;56(10):1241-9. PubMed PMID: 22946762.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Naloxone infusion and post-hysterectomy morphine consumption: a double-blind, placebo-controlled study. AU - Movafegh,A, AU - Shoeibi,G, AU - Ansari,M, AU - Sadeghi,M, AU - Azimaraghi,O, AU - Aghajani,Y, Y1 - 2012/09/04/ PY - 2012/07/31/accepted PY - 2012/9/6/entrez PY - 2012/9/6/pubmed PY - 2013/3/23/medline SP - 1241 EP - 9 JF - Acta anaesthesiologica Scandinavica JO - Acta Anaesthesiol Scand VL - 56 IS - 10 N2 - BACKGROUND: The evidence that an infusion of a low dose of naloxone reduces post-operative pain and opioid analgesic consumption is somewhat conflicting. Thus, the aim of the present study was to investigate the effect of an ultra-low dose of naloxone on patient-controlled morphine analgesia. METHODS: Ninety patients, 35-55 years old, scheduled for total abdominal hysterectomy, were enrolled in this prospective, randomized, double-blind and placebo-controlled study. Post-operatively, they received either saline (n = 45) or naloxone (n = 45) for 24 h. A standard general anesthesia was administered in both groups. In the recovery room, patients received morphine by a patient-controlled analgesia device. An ultra-low dose of naloxone was infused intravenously at 0.25 μg/kg/h for 24 h in the intervention group. Saline was infused in the control group. Following the surgery, morphine consumption, numeric rating score for pain intensity, nausea and vomiting, pruritus, and requests for antiemetic were recorded at baseline, 30 min, 1, 4, 8,16, 20, and 24 h following their discharge from recovery. RESULTS: Naloxone reduced morphine consumption over the first 24 post-operative hours significantly compared with the controls (saline) {19.5 [standard deviation (SD) 3.4] mg vs. 27.5 [SD 5.9] mg; P < 0.001}. The incidence and severity of nausea and vomiting was significantly reduced in the naloxone group. The incidence of pruritus and the pain scores at rest and activity were not significantly different. CONCLUSION: Following hysterectomy, an ultra-low dose of naloxone infusion proved to reduce morphine consumption as well as the incidence and severity of opioid-induced nausea and vomiting. SN - 1399-6576 UR - https://www.unboundmedicine.com/medline/citation/22946762/Naloxone_infusion_and_post_hysterectomy_morphine_consumption:_a_double_blind_placebo_controlled_study_ L2 - https://doi.org/10.1111/j.1399-6576.2012.02764.x DB - PRIME DP - Unbound Medicine ER -