Combination of fentanyl with low-dose naloxone for patient-controlled intravenous analgesia

Objective To find out a more effective drug compatibility method in preventing nausea and vomiting for patient-controlled intravenous analgesia(PCIA) by comparing the rate of nausea,vomiting,and analgesic effect of fentanyl in combination with low-dose naloxone or ondansetron. Methods Sixty patients underwent elective abdominal operations and received a standardized general anaesthesia were randomly divided into 3 groups: naloxone group(naloxone combined with fentanyl,n=20),ondansetron group(ondansetron combined with fentanyl,n=20)and control group( fentanyl alone,n=20). The rate of nausea and vomiting of patients in 24h,and visual analogue scale( VAS) for pain was evaluated in 2,6,12,24,48h after the operation. Results The total rate of nausea and vomiting was different in three groups(P0.05). The incidence of total nausea and vomiting in naloxone group was significantly lower than that in control group and ondansetron group(all P'0.0125). The incidence of severe nausea and vomiting in naloxone group was also significantly lower than that in control group(P'0.0125),but there were no difference among naloxone group and ondansetron group as well as ondansetron group and control group. VAS score of naloxone group was significantly lower than control group(P0.05),and there was no statistically significant difference of VAS score between ondansetron and control group(P0.05) 6 h after the operation. Conclusions 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.