Chen M-H, Xie L, Liu T-W, Song F-Q, He T
Institute of Cardiovascular Diseases, First Affiliated Hospital of Guangxi Medical University, Nanning, China.
Acta Anaesthesiol Scand. 2006 Oct;50(9):1125-30. doi: 10.1111/j.1399-6576.2006.01141.x.
It is not known whether naloxone is as efficacious as epinephrine during cardiopulmonary resuscitation (CPR). The aim of the study was to compare the effects of naloxone and epinephrine on the outcomes of CPR following asphyxial cardiac arrest in rats.
Cardiac arrest was induced with asphyxia by clamping the tracheal tubes. Twenty-four Sprague-Dawley rats were randomized prospectively into a saline group (treated with normal saline, 1 ml intravenously, n = 8), an epinephrine group (treated with epinephrine, 0.04 mg/kg intravenously, n = 8) or a naloxone group (treated with naloxone, 1 mg/kg intravenously, n = 8) in a blind fashion during resuscitation after asphyxial cardiac arrest. After 5 min of untreated cardiac arrest, conventional manual CPR was started and each drug was administered at the same time.
The rates of restoration of spontaneous circulation (ROSC) were one of eight (12.5%), seven of eight (87.5%) and seven of eight (87.5%) in the saline, epinephrine and naloxone groups, respectively. The rates of ROSC in the epinephrine and naloxone groups were equal and significantly greater than that in the saline group (P = 0.01 and P = 0.01, respectively).
The administration of naloxone or epinephrine alone may increase the resuscitation rate, and both drugs are equally effective for CPR in a rat asphyxia model. However, the mechanism by which naloxone produces its efficacy during CPR remains unclear and further experimentation will be necessary.
在心肺复苏（CPR）期间，纳洛酮是否与肾上腺素一样有效尚不清楚。本研究的目的是比较纳洛酮和肾上腺素对大鼠窒息性心脏骤停后心肺复苏结局的影响。
通过夹闭气管导管诱导窒息性心脏骤停。24只Sprague-Dawley大鼠在窒息性心脏骤停复苏期间被前瞻性随机分为生理盐水组（静脉注射1ml生理盐水，n = 8）、肾上腺素组（静脉注射0.04mg/kg肾上腺素，n = 8）或纳洛酮组（静脉注射1mg/kg纳洛酮，n = 8），采用盲法分组。在未经处理的心脏骤停5分钟后，开始常规手动心肺复苏，并同时给予每种药物。
生理盐水组、肾上腺素组和纳洛酮组的自主循环恢复（ROSC）率分别为八分之一（12.5%）、八分之七（87.5%）和八分之七（87.5%）。肾上腺素组和纳洛酮组的ROSC率相等，且显著高于生理盐水组（分别为P = 0.01和P = 0.01）。
单独给予纳洛酮或肾上腺素可能会提高复苏率，并且这两种药物在大鼠窒息模型中对心肺复苏同样有效。然而，纳洛酮在心肺复苏期间产生疗效的机制仍不清楚，需要进一步实验研究。
