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The effects of a small-dose naloxone infusion on opioid-induced side effects and analgesia in children and adolescents treated with intravenous patient-controlled analgesia: a double-blind, prospective, randomized, controlled study
- Source :
- Anesthesia and analgesia. 100(4)
- Publication Year :
- 2005
-
Abstract
- Opioids are frequently associated with side effects such as nausea, vomiting, and pruritus. We hypothesized that a prophylactic, continuous small-dose naloxone infusion would reduce the incidence of opioid-induced side effects without affecting analgesia or opioid consumption. In this prospective, double-blind, randomized, controlled clinical trial, we studied 46 postoperative patients (M:F, 21:25), averaging 14 +/- 2.5 yr and 53 +/- 17 kg, at the start of morphine IV patient-controlled analgesia. Patients were randomized to either saline (control, n = 26) or naloxone 0.25 microg . kg(-1) . h(-1) (n = 20). We found that the incidence and severity of pruritus (77% versus 20%; P0.05) and nausea (70% versus 35%; P0.05) was significantly more frequent in the placebo group compared with the naloxone group. Morphine consumption (1.02 +/- 0.41 mg . kg(-1) . d(-1) versus 1.28 +/- 0.61 mg . kg(-1) . d(-1)), pain scores at rest (4 +/- 2 versus 3 +/- 2), and pain scores with coughing (6 +/- 2 versus 6 +/- 2) were not different. We conclude that, in children and adolescents, a small-dose naloxone infusion (0.25 microg . kg(-1) . h(-1)) can significantly reduce the incidence and severity of opioid-induced side effects without affecting opioid-induced analgesia. When initiating morphine IV patient-controlled analgesia for the treatment of moderate to severe pain, clinicians should strongly consider starting a concomitant small-dose naloxone infusion.
- Subjects :
- Adult
Male
medicine.medical_specialty
Adolescent
Nausea
Narcotic Antagonists
law.invention
Double blind
Randomized controlled trial
Double-Blind Method
law
Naloxone
medicine
Humans
Prospective Studies
Child
Infusions, Intravenous
Pain Measurement
Pain, Postoperative
Narcotic antagonist
business.industry
Pruritus
Analgesia, Patient-Controlled
Surgery
Analgesics, Opioid
Anesthesiology and Pain Medicine
Opioid
Anesthesia
Postoperative Nausea and Vomiting
Vomiting
Female
medicine.symptom
Analgesia
business
medicine.drug
Intravenous Patient-Controlled Analgesia
Subjects
Details
- ISSN :
- 00032999
- Volume :
- 100
- Issue :
- 4
- Database :
- OpenAIRE
- Journal :
- Anesthesia and analgesia
- Accession number :
- edsair.doi.dedup.....2c926e35b423ac4cccde5dc4d8acdb1a