Lactulose Versus Naloxone for Opioid-Induced Constipation in Intensive Care

Constipation caused by opioid-induced constipation (OIC) is prevalent among critically poisoned patients and can result in complications that prolong hospitalization and, in rare cases, cause bowel perforatio This research aimed to evaluate the safety and efficacy of lactulose and naloxone in the treatment of OIC in the intensive care unit for poisoning.

This was a randomized, double-blind, clinical trial of patients with opioid poisoning who experienced constipation for 14 months. Patients were divided into two groups: one receiving lactulose (30 cc daily) and the other receiving naloxone (8 mg three times a day). The parameters of age, gender, type of opioid used, Acute Physiology and Chronic Health Evaluation II score, Glasgow Coma Scale score, defecation time, and number of laboratory variables were recorded. All data were collected and analyzed using SPSS software.

Of the participants in the lactulose group, 85.37% were male and 14.63% were female. In the naloxone group, 94.9% of patients were male and 5.1% were female. The average age of the lactulose group was 44 ± 16.2 and in the naloxone group was 48.13 ± 19.1 years. The average defecation time was 30.8 ± 23.1 hours in the naloxone group and 25 ± 11.5 hours in the lactulose group. Six patients (15%) in the naloxone group experienced treatment failure. Symptoms of withdrawal syndrome were experienced by 15 patients (39.5%) patients in the naloxone group.

The evidence suggests that lactulose is a superior treatment choice because it does not carry the risk of withdrawal syndrome or treatment ineffectiveness.