Marco Catherine A, Trautman William, Cook Alexander, Mann Dennis, Rasp Jordan, Perkins Oswald, Ballester Michael
Department of Emergency Medicine, Wright State University, Boonshoft School of Medicine, Dayton, Ohio.
Wright State University, Boonshoft School of Medicine, Dayton, Ohio.
J Emerg Med. 2018 Jul;55(1):64-70. doi: 10.1016/j.jemermed.2018.04.022.
Emergency department (ED) visits for unintentional opioid overdoses have increased dramatically. Naloxone hydrochloride (Narcan®) is an opioid antagonist commonly used to treat these overdoses.
This study was undertaken to identify experiences regarding naloxone use among ED patients with opioid overdose.
This prospective survey study was conducted at an urban level I trauma center. A survey was administered to eligible ED patients after unintentional opioid overdose. This study identified current and previous use of naloxone among ED patients with opioid overdose.
Eight-nine ED patients with accidental overdose of opioids participated (90% participation rate). Most participants reported a history of opioid overdose (n = 62 [70%]). A significant minority stated they have had access to a naloxone kit (n = 28 [31%]). Most participants with a naloxone kit stated that their frequency and dosage of opiate use did not change after access to naloxone (n = 17 [63%]), and a few used opiates more often (n = 1 [4%]) or less often (n = 9 [33%]). There was a significant negative correlation between total dose and age (Spearman ρ -0.27; p = 0.01). There was no association between dose and sex.
Many patients presenting with opioid overdose have had a history of opioid overdose. Patients with opioid overdose required a highly variable dose of naloxone. Higher doses of naloxone were associated with lower age. Despite widespread availability of naloxone to consumers, a minority of patients in this study reported access to naloxone. Participants who had access to a naloxone kit stated that their frequency and dosage of opioid use did not change.
因非故意阿片类药物过量导致的急诊科就诊人数急剧增加。盐酸纳洛酮（纳曲酮）是一种常用于治疗此类过量中毒的阿片类拮抗剂。
本研究旨在确定急诊科阿片类药物过量患者使用纳洛酮的经历。
这项前瞻性调查研究在一家城市一级创伤中心进行。对符合条件的非故意阿片类药物过量的急诊科患者进行了调查。本研究确定了急诊科阿片类药物过量患者当前和既往使用纳洛酮的情况。
八十九名意外过量服用阿片类药物的急诊科患者参与了研究（参与率为90%）。大多数参与者报告有阿片类药物过量史（n = 62 [70%]）。少数人表示他们能够获得纳洛酮试剂盒（n = 28 [31%]）。大多数拥有纳洛酮试剂盒的参与者表示，在获得纳洛酮后，他们使用阿片类药物的频率和剂量没有变化（n = 17 [63%]），少数人使用阿片类药物更频繁（n = 1 [4%]）或更不频繁（n = 9 [33%]）。总剂量与年龄之间存在显著负相关（斯皮尔曼ρ -0.27；p = 0.01）。剂量与性别之间没有关联。
许多出现阿片类药物过量的患者有阿片类药物过量史。阿片类药物过量患者所需的纳洛酮剂量差异很大。纳洛酮剂量越高，年龄越小。尽管纳洛酮已广泛提供给消费者，但本研究中的少数患者报告能够获得纳洛酮。获得纳洛酮试剂盒的参与者表示，他们使用阿片类药物的频率和剂量没有变化。
