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Intrathecal morphine is an analgesic option for major hepatopancreaticobiliary procedures but is associated with a risk of respiratory depression. We hypothesised that a postoperative low-dose naloxone infusion would reduce the incidence of respiratory depression without an increase in pain scores. Patients scheduled for major open hepatopancreaticobiliary surgery and who were receiving 10 μg.kg-1 intrathecal morphine were eligible for inclusion. Patients were allocated randomly to receive a postoperative infusion of naloxone 5 μg.kg-1 .h-1 (naloxone group) or saline at an identical infusion rate (control group) until the morning after surgery. Clinicians, nursing staff and patients were blinded to group allocation. The primary outcome measure was the incidence of respiratory depression (respiratory rate -1 and/or oxygen saturation

Original publication

DOI

10.1111/anae.14931

Type

Journal

Anaesthesia

Publication Date

06/2020

Volume

75

Pages

747 - 755

Addresses

Department of Anaesthesia, St. Vincent's University Hospital, Dublin, Ireland.

Keywords

Liver, Humans, Digestive System Diseases, Respiratory Insufficiency, Pain, Postoperative, Morphine, Naloxone, Analgesics, Opioid, Narcotic Antagonists, Biliary Tract Surgical Procedures, Infusions, Intravenous, Injections, Spinal, Incidence, Adult, Aged, Middle Aged, Female, Male, Young Adult