Barsan W G, Seger D, Danzl D F, Ling L J, Bartlett R, Buncher R, Bryan C
Department of Emergency Medicine, University of Cincinnati College of Medicine, OH 45267-0769.
Am J Emerg Med. 1989 Mar;7(2):155-61. doi: 10.1016/0735-6757(89)90128-9.
Naloxone is an effective opiate antagonist, but its short half-life limits its usefulness. For outpatient procedures, a longer acting opiate antagonist could eliminate two to four hours of nursing observation in patients postoperatively. A controlled, randomized, double-blind trial comparing the effects of nalmefene, naloxone, and placebo in reversing opiate-induced sedation was carried out to determine efficacy, duration of action, and adverse effects in patients undergoing outpatient procedures. Each patient received 1.5 to 3.0 mg/kg meperidine intravenously before the procedure. After the procedure, each patient received either nalmefene, 1.0 mg; naloxone, 1.0 mg; or saline, 1.0 mL intravenously. Vital signs and assessments for alertness were performed for four hours. Naloxone significantly reversed sedation for only 15 minutes, whereas nalmefene was significantly effective (P less than .05) for up to 210 minutes. Nalmefene was significantly more effective than naloxone in reversing sedation at 60, 90, and 120 minutes. Nalmefene is an effective agent for the reversal of opiate-induced sedation after outpatient procedures.
纳洛酮是一种有效的阿片类拮抗剂，但其半衰期短限制了其效用。对于门诊手术，一种作用时间更长的阿片类拮抗剂可省去术后患者两到四小时的护理观察。开展了一项对照、随机、双盲试验，比较纳美芬、纳洛酮和安慰剂在逆转阿片类药物引起的镇静作用方面的效果，以确定门诊手术患者的疗效、作用持续时间和不良反应。每位患者在手术前静脉注射1.5至3.0毫克/千克哌替啶。手术后，每位患者静脉注射纳美芬1.0毫克、纳洛酮1.0毫克或生理盐水1.0毫升。对生命体征和清醒程度进行了四小时的评估。纳洛酮仅在15分钟内显著逆转了镇静作用，而纳美芬在长达210分钟内都有显著效果（P小于0.05）。在60、90和120分钟时，纳美芬在逆转镇静作用方面比纳洛酮显著更有效。纳美芬是门诊手术后逆转阿片类药物引起的镇静作用的有效药物。
