Application of low dose naloxone in postoperative patient-controlled intravenous analgesia(PCIA)with fentanyl

Objective To observe the reduced adverse reaction of fentanyl with the application of low dose naloxone in postoperative PCIA with fentanyl and to find the suitable dosage of naloxone.Methods Two hundred and thirty eight general anesthesia cases with abdomen operation were randomly divided into three groups of group A with fentanyl 10～20μg/kg,desamethasone 5mg and normal saline 100ml,group B with naloxone 5μg/kg to be added and group C with naloxone 10μg/kg to be added.The visual analogue scale(VAS),dosage of fentanyl and the incidences of nausea and vomiting as well as itch were evaluated timely and recorded.Results The doses of fentanyl had not significant difference among the three groups.The pump rates of naloxone in B and C groups were 0.01±0.12 μg/(kg.h)and 0.30±0.19 μg /(kg.h)(P0.01),respectively.The incidence of nausea and vomiting and incidence of itch were reduced in B and C groups and had significant difference compared with group A(P0.05,P0.01).The VAS grades were similar within the 24h postoperative period among the three groups.Conclusion Low dose naloxone added to fentanyl and pumped as the rate of 0.10～0.30 μg /(kg.h) in postoperative PCIA is feasible and the incidences of the side effects of fentanyl can be decreased.