Epidural naloxone reduces postoperative nausea and vomiting in patients receiving epidural sufentanil for postoperative analgesia

Abstract

Epidural naloxone was effective in reducing PONV induced by epidural sufentanil and additionally enhanced the analgesic effect. Therefore, concomitant infusion of a small dose of epidural naloxone should be considered to reduce PONV, especially in patients at greater risk for PONV.

Effects of preoperative, scheduled administration of antiemetics on reducing postoperative nausea and vomiting in patients undergoing total knee arthroplasty

“…In terms of postoperative pain and complications, there were no significant differences between the two groups. Previously, it was revealed that PONV control reduced the pain VAS (20,21). In this study, there were no significant differences in pain and satisfaction VAS scores.…”

Naloxone added to bupivacaine or bupivacaine–fentanyl prolongs motor and sensory block during supraclavicular brachial plexus blockade: a randomized clinical trial

“…Other data suggest that an ultra‐low dose of naloxone augmented the anti‐nociceptive effect of morphine by enhancing the reuptake of excitatory amino acids from the synaptic cleft . Human studies from 2001 and 2007 imply that applying low doses of naloxone intrathecally could reduce opioid side effects and enhance analgesia . Results in an earlier study suggested that naloxone in low doses could release endorphins, or probably relocate endorphins from receptor sites .…”

Low‐Dose Naloxone for Prophylaxis of Postoperative Nausea and Vomiting: A Systematic Review and Meta‐analysis

“…Postoperative epidural administration of naloxone and opioids was omitted from our meta‐analysis. Studies have demonstrated efficacy of epidural naloxone in PONV . However, pharmacokinetic dissimilarities between epidural and intravenous administration of naloxone and opioids excluded these trials from collective data analysis.…”

“…Studies have demonstrated efficacy of epidural naloxone in PONV. 35,36 However, pharmacokinetic dissimilarities between epidural and intravenous administration of naloxone and opioids excluded these trials from collective data analysis. Finally, whereas seven of the nine studies administered morphine for analgesia, 11,[16][17][18][19][20][21] two studies used tramadol or fentanyl in managing postsurgical pain.…”