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Pediatric patients receiving naloxone within 48 h of anesthesia: a case-control study

Vinay K Donempudi1, Juraj Sprung1, Toby N Weingarten2

  • 1Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA.

Pediatric Surgery International
|November 11, 2017
PubMed

Insights

Postoperative naloxone use in pediatric surgery is uncommon, typically for respiratory issues or sedation reversal. Most administrations occurred in monitored settings, indicating appropriate identification of at-risk pediatric patients.

Area of Science:

  • Pediatric Anesthesiology
  • Pharmacology
  • Surgical Care

Background:

  • Excessive narcotization in pediatric surgical patients is not well understood.
  • Limited data exists on the use of naloxone in this population.

Purpose of the Study:

  • To characterize the use of postoperative naloxone in pediatric surgical patients.
  • To describe indications, dosing, and outcomes associated with naloxone administration.

Main Methods:

  • Retrospective chart review of pediatric surgical patients from January 2010 to June 2016.
  • Matched 1:1 comparison of patients receiving naloxone (cases) with controls by age, sex, and procedure.
  • Analysis of naloxone indications, dose, setting, and patient outcomes.

Main Results:

  • Naloxone was administered at a rate of 2.0 per 1000 anesthetics.
  • Indications included respiratory depression, facilitating extubation, and reversing sedation.
  • Most administrations (44/47) occurred in a monitored setting; outcomes were similar to controls.

Conclusions:

  • Postoperative naloxone administration in pediatric patients is rare.
  • The high rate of administration in monitored settings suggests appropriate identification of at-risk patients.
  • Further research may clarify optimal use and monitoring strategies.
Abstract

Keywords:
AnalgesicsGeneral anesthesiaHypoventilationNarcotic antagonistsPostoperative complicationsSurgery

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