[Naloxone and endotoxic shock: a wonder drug?]

Naloxone clorhidrate was administered intravenously to 15 patients with endotoxic shock and refractary hypotension, following meningococcal sepsis. Doses used were between 0.01-0.2 mg/kg. Three patients (two of them with moderate shock) showed an increase in sistolic arterial pressure, which was maintained and above 20 mm/Hg. Among the rest of them (except one with severe shock) naloxone action was non-existent in nine cases, or with short action and without answer to next doses in other three. Eleven patients died. A blood pressure increase was maintained only in two of the four survivors. Usefulness of naloxone in this kind of patients is not clear. Presence in endotoxin shock of a variety of refractory factors besides beta endorphins, greatly limits therapeutic efficiency of this drug.