[Endocrine and hemodynamic effects of naloxone following modified neuroleptanesthesia]

This study was undertaken to investigate the influence of the opiate-antagonist naloxone on the endocrine stress response and haemodynamic parameters after modified neuroleptanaesthesia in a randomized, prospective design. A total number of 22 patients (ASA-scores I or II) between 18 and 60 years scheduled for major gynaecologic surgery were included. For modified neuroleptanaesthesia, midazolam, fentanyl and vecuronium were administered in standardized doses. After extubation, patients of the naloxone-group received injections of 2 x 0.1 mg naloxone; in controls, no naloxone was used. Endocrine stress parameters and haemodynamic parameters were measured 7 times before induction of anaesthesia and up to 60 minutes after the operation. In both groups, remarkable increases in adrenaline, noradrenaline, antidiuretic hormone, adrenocorticotropic hormone, cortisol, glucose and lactate took place in the postoperative period. This stress response was comparable in both groups and not increased by naloxone. No significant influence of naloxone on mean arterial pressure, heart rate and arterial oxygen saturation was observed. After neuroleptanaesthesia, a careful opiate antagonism with small doses of naloxone is not disadvantageous with respect to endocrine stress response and haemodynamic reactions.