患者自行选择低剂量静脉注射纳洛酮用于快速丁丙诺啡诱导：一例病例报告。
Patient-elected low-dose intravenous naloxone for rapid buprenorphine induction: a case report.
作者信息
Azar Pouya, Machado Jessica, Kim Jane J, Wong James S H, Nikoo Mohammadali, Li Victor W
机构信息
Complex Pain and Addiction Service, Vancouver General Hospital, Vancouver, BC, Canada.
Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada.
出版信息
Addict Sci Clin Pract. 2025 May 14;20(1):42. doi: 10.1186/s13722-025-00572-z.
BACKGROUND
Buprenorphine is a common partial opioid agonist treatment for opioid use disorder (OUD). Despite its efficacy, major challenges to induction include the significant time consumption and the difficult requirement for patients to be in moderate opioid withdrawal.
CASE PRESENTATION
We present the case of a 31-year-old man with severe OUD and regular fentanyl use who was successfully initiated on buprenorphine-naloxone using low-dose intravenous naloxone in ten minutes and administered 300 mg of extended-release injectable buprenorphine within two hours. This involved the rapid administration of small doses of intravenous naloxone with an assessment of withdrawal symptoms after each dose. Buprenorphine-naloxone is immediately administered once moderate withdrawal is reached.
CONCLUSIONS
Low-dose intravenous naloxone provides an alternative method of buprenorphine induction that limits the experience of withdrawal to a shorter time window compared to existing protocols.
背景
丁丙诺啡是治疗阿片类物质使用障碍（OUD）的常用部分阿片类激动剂。尽管其疗效显著，但诱导治疗面临的主要挑战包括耗时较长以及要求患者处于中度阿片类物质戒断状态。
病例介绍
我们报告一例31岁患有严重OUD且经常使用芬太尼的男性患者，使用低剂量静脉注射纳洛酮在10分钟内成功启动丁丙诺啡 - 纳洛酮治疗，并在两小时内给予300毫克长效注射用丁丙诺啡。这包括快速静脉注射小剂量纳洛酮，并在每次给药后评估戒断症状。一旦达到中度戒断状态，立即给予丁丙诺啡 - 纳洛酮。
结论
与现有方案相比，低剂量静脉注射纳洛酮提供了一种丁丙诺啡诱导的替代方法，可将戒断体验限制在更短的时间范围内。
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