Combination Of Fentanyl With Low-dose Naloxone For Intravenous Patient-controlled Analgesia

Objective To find a more effective in preventing nausea and vomiting compoundings for PCIA compared the rate of nausea,vomiting,and analgesic effect for intravenous patient-controlled analgesia(PCIA) between low-dose naloxone and ondansetron.Method Sixty patients(18-65 years old,18.5-24kg/m~2) undergoing selective abdominal operations who received a standardized general anaesthesia with an American Society of Anesthesiologist physical statusâ… orâ…¡were randomized to 3 groups:Naloxone group(naloxone combined with fentanyl),Ondansetron group(ondansetron combined with fentanyl) and Control group(fentanyl alone).The rate of fentanyl,nausea and vomiting in 24h,and visual analogue scale(VAS) for pain in 2,6,12,24,48h was evaluated.Results Sixty patients completed the study.There was no difference in fentanyl rate between the groups(P>0.05 ).Naloxone group was effective in reducing the incidence of total nausea and vomiting,and severe nausea and vomiting compared with control group(P < 0.0167),furthermore,the differences in reducing the incidence of total nausea and vomiting was significant compared with ondansetron group(P < 0.0167),but was not significant in severe nausea and vomiting (P>0.0167).But the differences of the incidence of total nausea and vomiting,and severe nausea and vomiting between ondansetron group and control group was not significant (P>0.0167).The VAS between ondansetron group and control group was not significantly different in all periods(P>0.05),but was significant between naloxone group and control group in 6h(P<0.05).Conclusions Low-dose naloxone combined fentanyl for PCIA significantly reduced the rate of nausea and vomiting,with ondansetron didn't.Otherwise,the former's VAS was lower than fentanyl alone in 6h,with ondansetron wasn't.Compared with ondansetron,low-dose naloxone combined fentanyl for PCIA can not only reduce the rate of nausea and vomiting,but also enhance the analgesic effect of fentanyl. Besides,there's some economic advantages in naloxone group.