Open AccessThe effect of naloxone treatment on opioid-induced side effects
Author(s) -
Fangping He,
You-Ming Jiang,
Li Li
Publication year - 2016
Publication title -
medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.59
H-Index - 148
eISSN - 1536-5964
pISSN - 0025-7974
DOI - 10.1097/md.0000000000004729
Subject(s) - medicine , nausea , meta analysis , confidence interval , vomiting , opioid , publication bias , placebo , (+) naloxone , strictly standardized mean difference , anesthesia , alternative medicine , receptor , pathology
Background: To evaluate the effects of naloxone on opioid-induced side effects, the present meta-analysis was constructed. Methods: Electronic databases including PubMed, EMBASE, and CNKI (China National Knowledge Internet) were used for literature search. Studies on comparison of opioid-side effects between naloxone-treated group and placebo or normal saline-related group were included in the meta-analysis. Heterogeneity analysis was performed with Chi-square and I 2 test. Pooled analysis was based on fixed-effects model, if heterogeneity between the eligible studies was negligible ( I 2 < 50%, P > 0.05), otherwise, random-effects model was used. Sensitivity analysis was applied to assess the robustness of the results and publication bias was evaluated by Begg and Egger test. Results: Thirteen studies including 1138 patients were included in the meta-analysis. Pooled analysis indicated that naloxone could significantly reduce the occurrence of pruritus (RR [risk ratio] = 0.252, 95% CI [confidence interval] = 0.137–0.464), nausea (RR = 0.323, 95% CI = 0.245–0.428), and vomiting (RR = 0.338, 95% CI = 0.192–0.593) which were induced by opioids. However, naloxone did not relieve pain (standardized mean difference [SMD] = −0.052, 95% CI = −0.453 to 0.348) and somnolence (RR = 0.561, 95% CI = 0.287 to 1.097) in patients received opioid treatment. Additionally, there were no significant publication bias between the included studies (Begg test, P = 0.602; Egger test, P = 0.388). Conclusion: Addition of naloxone might act as an effective treatment for prophylaxis of opioid-induced pruritus, nausea, and vomiting in clinical practice.