The effect of naloxone treatment on opioid-induced side effects: A meta-analysis of randomized and controlled trails

To evaluate the effects of naloxone on opioid-induced side effects, the present meta-analysis was constructed.

Electronic databases including PubMed, EMBASE, and CNKI (China National Knowledge Internet) were used for literature search. Studies on comparison of opioid-side effects between naloxone-treated group and placebo or normal saline-related group were included in the meta-analysis. Heterogeneity analysis was performed with Chi-square and I test. Pooled analysis was based on fixed-effects model, if heterogeneity between the eligible studies was negligible (I < 50%, P > 0.05), otherwise, random-effects model was used. Sensitivity analysis was applied to assess the robustness of the results and publication bias was evaluated by Begg and Egger test.

Thirteen studies including 1138 patients were included in the meta-analysis. Pooled analysis indicated that naloxone could significantly reduce the occurrence of pruritus (RR [risk ratio] = 0.252, 95% CI [confidence interval] = 0.137-0.464), nausea (RR = 0.323, 95% CI = 0.245-0.428), and vomiting (RR = 0.338, 95% CI = 0.192-0.593) which were induced by opioids. However, naloxone did not relieve pain (standardized mean difference [SMD] = -0.052, 95% CI = -0.453 to 0.348) and somnolence (RR = 0.561, 95% CI = 0.287 to 1.097) in patients received opioid treatment. Additionally, there were no significant publication bias between the included studies (Begg test, P = 0.602; Egger test, P = 0.388).

Addition of naloxone might act as an effective treatment for prophylaxis of opioid-induced pruritus, nausea, and vomiting in clinical practice.