Naloxone for shock

Naloxone may be beneficial in septic shock, but the number of patients studied is small and there is a possibility of publication bias.

A Cochrane review included 6 studies with a total of 126 subjects with septic, cardiogenic, hemorrhagic, or spinal shock. Naloxone therapy was associated with statistically significant hemodynamic improvement (OR 0.24, 95% CI 0.09 to 0.68). The mean arterial pressure was significantly higher in the naloxone groups than in the placebo groups (WMD +9.33 mm Hg, 95% CI 7.07 to 11.59; 3 studies, n=66). There was no statistically significant difference in the death rate, although the trend favored naloxone (OR 0.59, 95% CI 0.21 was 1.67; significant heterogeneity I²=67%; 3 studies, n=59).

Comment: The quality of evidence is downgraded by imprecise results (few patients and wide confidence intervals) and by potential reporting bias (only few small trials reported).

Ədəbiyyat

1. Boeuf B, Poirier V, Gauvin F, Guerguerian AM, Roy C, Farrell CA, Lacroix J. Naloxone for shock. Cochrane Database Syst Rev 2003;(4):CD004443 [Review content assessed as up-to-date: 4 December 2008]