Dadpour Bita, Vahabzadeh Maryam, Mostafazadeh Babak
Medical Toxicology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
Toxicological Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Acute Crit Care. 2020 Feb;35(1):38-43. doi: 10.4266/acc.2020.00010. Epub 2020 Feb 29.
The optimal goal of naloxone infusion in intensive care units is to ameliorate opioid-induced side effects in therapy or eliminate the symptoms of opioid toxicity in overdoses. Accurately monitoring and regulating the doses is critical to prevent adverse effects related to naloxone administration. The present study aimed to compare treatment outcomes when using two methods of intravenous naloxone infusion: an infusion pump or the standard method.
This study involved 80 patients with signs and symptoms of opioid overdose. The patients were randomly assigned into two groups with respect to intravenous infusion of naloxone by either an infusion pump or the standard method.
Comparison of study parameters between the two groups at 12 and 24 hours after intervention showed significantly more compensatory acid-base imbalance in the naloxone infusion pump group. In the group that received naloxone by pump, only one patient experienced withdrawal symptoms, but withdrawal symptoms appeared in 12 patients (30.0%) in the standard intravenous infusion group within 12 hours and in seven additional patients (17.5%) within 24 hours of intervention. In the group receiving pump-based naloxone infusion therapy, no another complications were reported; however in the standard infusion group, the 12-hour and 24-hour complication rates were 55.0% and 32.5%, respectively. The length of hospital stay was 2.85±1.05 and 4.22±0.92 days for the pump and standard infusion groups, respectively (P<0.001).
Naloxone infusion using an infusion pump may be safer with regard to hemodynamic stability, resulting in shorter hospitalization periods, and fewer posttreatment complications.
重症监护病房中纳洛酮输注的最佳目标是改善治疗中阿片类药物引起的副作用或消除过量使用阿片类药物导致的中毒症状。准确监测和调整剂量对于预防与纳洛酮给药相关的不良反应至关重要。本研究旨在比较两种静脉注射纳洛酮的方法：输液泵法和标准方法的治疗效果。
本研究纳入了80例有阿片类药物过量体征和症状的患者。根据纳洛酮静脉输注方法，将患者随机分为两组，分别采用输液泵法或标准方法。
干预后12小时和24小时两组研究参数比较显示，纳洛酮输液泵组代偿性酸碱失衡明显更多。在接受输液泵输注纳洛酮的组中，只有1例患者出现戒断症状，但在标准静脉输注组中，12例患者（30.0%）在干预后12小时内出现戒断症状，另外7例患者（17.5%）在干预后24小时内出现戒断症状。在接受基于输液泵的纳洛酮输注治疗的组中，未报告其他并发症；然而，在标准输注组中，12小时和24小时的并发症发生率分别为55.0%和32.5%。输液泵组和标准输注组的住院时间分别为2.85±1.05天和4.22±0.92天（P<0.001）。
就血流动力学稳定性而言，使用输液泵输注纳洛酮可能更安全，可缩短住院时间，减少治疗后并发症。
