Nasseri Karim, Ahsan Behzad, Farhadifar Fariba, Shami Shoaleh
Department of Anesthesia and Intensive Care, Kurdistan University of Medical Sciences, Kurdistan, Iran.
Acta Med Iran. 2010 Jan-Feb;48(1):27-32.
Ultra rapid opioid detoxification (UROD) is one of the new methods of detoxification. This method of detoxification involves putting patients under general anesthesia and actively giving them opioid antagonists. The objective of this study was to evaluate effects of anesthesia duration in UROD on severity of withdrawal syndrome. Sixty addicted patients seeking UROD procedure assigned randomly to one of the 2 hr, 4 hr or 6 hr anesthesia duration groups. Premedication and anesthesia procedure (induction and maintenance) were the same for three groups. Detoxification was done for all patients with 50 mg oral naltroxane (prior to induction) and 20 mg intravenous naloxane (8 mg/bolus and 12 mg/infusion). Blood pressure, heart rate and respiratory rate were automatically measured and recorded every 5 minutes. The severity of withdrawal syndrome was measured and recorded every one hour during anesthesia, 2 hours post-anesthesia, and 12 and 24 hours following the induction of anesthesia according to the Wang Scale modified by Lomier (WSMBL). Patients aged 20-58 in three groups. Three cases experienced delirium after detoxification that lasted 24 hours in one. Severity of withdrawal syndrome in patients of groups 2, 4 and 6 hour were 8.7, 7.4 and 5.1 respectively during anesthesia and 12.3, 11.1 and 13.9 after 18 hours of anesthesia. Results of this study showed that, in standard settings, UROD is a safe method for detoxification and has low complications. The withdrawal symptoms during and after anesthesia are low. Shortening the duration of anesthesia has no affect on severity of withdrawal syndrome during and after anesthesia.
超快速阿片类药物脱毒（UROD）是一种新型脱毒方法。这种脱毒方法是让患者处于全身麻醉状态，并积极给予他们阿片类拮抗剂。本研究的目的是评估UROD中麻醉持续时间对戒断综合征严重程度的影响。60名寻求UROD治疗的成瘾患者被随机分配到2小时、4小时或6小时麻醉持续时间组中的一组。三组的术前用药和麻醉程序（诱导和维持）相同。所有患者在诱导前口服50毫克纳曲酮，诱导后静脉注射20毫克纳洛酮（8毫克/推注和12毫克/输注）进行脱毒。每5分钟自动测量并记录血压、心率和呼吸频率。根据Lomier修改的Wang量表（WSMBL），在麻醉期间、麻醉后2小时、麻醉诱导后12小时和24小时每小时测量并记录戒断综合征的严重程度。三组患者年龄在20 - 58岁之间。有3例患者脱毒后出现谵妄，其中1例持续24小时。2小时、4小时和6小时组患者在麻醉期间戒断综合征的严重程度分别为8.7、7.4和5.1，麻醉18小时后分别为12.3、11.1和13.9。本研究结果表明，在标准设置下，UROD是一种安全的脱毒方法，并发症少。麻醉期间和之后的戒断症状较轻。缩短麻醉持续时间对麻醉期间和之后戒断综合征的严重程度没有影响。
