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Antagonism of Fentanyl with Naloxone during N 2 O+O 2 + Halothane Anaesthesia
Author(s) -
Tigerstedt Irma
Publication year - 1977
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/j.1399-6576.1977.tb01248.x
Subject(s) - medicine , fentanyl , halothane , anesthesia , antagonism , (+) naloxone , opioid , receptor
To investigate the antagonistic effect of naloxone on fentanyl‐induced respiratory depression, 55 patients (randomly divided into various study and control groups) were studied during nitrous‐oxide‐oxygen‐halothane anaesthesia. Respiratory depression after 0.1 mg of fentanyl was totally reversed by 10 μg/kg of naloxone, measured as 100% restoration of spontaneous respiration, normal minute volumes and end‐tidal CO 2 , while 15 μg/kg of naloxone was needed to antagonize 0.2 mg of fentanyl. The respective control groups remained apnoeic. If no fentanyl had previously been administered, there was no difference in the respiratory behaviour of naloxone‐treated and control patients, which indicates that no unspecific analeptic effect of naloxone could be demonstrated. The circulatory changes after fentanyl were nearly reversed by naloxone, as has been found earlier with other narcotics. Recovery from anaesthesia was scored from 0 to 10 (using a modification of Apgar scores for newborns), and somewhat higher mean scores were obtained with the naloxone‐treated patients than with their controls. However, higher postoperative pain scores were recorded in these patients as well as a higher incidence of nausea and vomiting. The study demonstrates the dose‐relationships of fentanyl and naloxone for estimation of total antagonism; however, the use of naloxone for partial antagonism at the termination of anaesthesia cannot be based on these findings.