Reversal of Morphine Anesthesia with Naloxone

Gonadal steroids do not affect basal growth hormone response to naloxone in humans

“…Detailed doseresponse studies of naloxone in humans have shown that doses as low as 0.0035-0.007 mg/kg provide excellent blockade of opiate action in the central nervous system (Jasinski et al 1967). Obviously, much larger doses are greatly in excess of what has been demonstrated to be centrally active and additional pharmacological effects may occur (Johnstone et al 1974). Moreover our findings are consistent with previous reports (Morley et al 1980;Volavka et al 1980;Delitala et al 1981) in which doses of naloxone considerably greater than 2 mg were not able to modify basal GH secretion in humans, even though, in these studies, gender differences was not considered.…”

Studies on benzodiazepines and opioids administered alone and in combination in rhesus monkeys: ventilation and drug discrimination

“…In humans, the subjective effects of a combination of methadone and diazepam were more pronounced than the subjective effects of either drug alone and subjects more frequently identified the drug combination as being like sedatives rather 172 antagonized by small doses of quadazocine or naltrexone (Howell et al 1988;Butelman et al 1993). In humans, the effects of opioids are similar to those observed in rhesus monkeys; opioids decrease V E as well as the ventilatory response to CO 2 (Bellville et al 1968;Weil et al 1975;Stoeckel et al 1982), and these effects are antagonized by naloxone (Johnstone et al 1974;Amin et al 1995). Consistency in the effects of opioids on ventilation between human and non-human primates further attests to the validity of examining interactions between benzodiazepines and opioids in rhesus monkeys.…”

Naloxone reversal of opioid anesthesia revisited: clinical evaluation and plasma concentration analysis of continuous naloxone infusion after anesthesia with high-dose fentanyl

“…Johnstone et al [10] reported that, in 7 healthy volunteers, naloxone infused at a dose of 3.66 µg·kg Ϫ1 ·h Ϫ1 effectively reversed the decreased CO 2 response induced by 2 mg·kg Ϫ1 of morphine. Shupak and Harp [11] successfully maintained each of 10 neurosurgical patients without mechanical ventilation after 20-µg·kg Ϫ1 sufentanil or 100-µg·kg Ϫ1 fentanyl, using bolus naloxone followed by infusion at doses of 4-5 µg·kg Ϫ1 ·h Ϫ1 for 16 h postoperatively.…”

“…However, postoperative naloxone use can involve several adverse effects, including renarcotization due to the short duration of action of this agent, and symptoms that are, presumably, related to "acute abstinence" from the opioid effects, such as pain, psychological stimulation, or sympathomimetic responses, of which the most severe is pulmonary edema [7][8][9]. To avoid such disadvantages, several studies have previously evaluated the effectiveness of continuous naloxone infusion after high-dose opioid anesthesia [10][11][12]. However, because of the relatively small number of subjects and limited extent of the surgical procedures, as well as the fixed-dose protocols of both the opioid and the naloxone administration in these studies, a clinically relevant regimen for postoperative naloxone infusion remains to be clarified.…”