Intranasal Versus Intravenous Naloxone in Opium Poisoning in Children, A Pilot Study

Journal of Comprehensive Pediatrics

ARTICLE

Farnaghi, Fariba¹  Elyassi, Maryam¹  Gachkar, Latif²  Gholami, Narges¹ 

[1] Department of Pediatrics, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences;Clinical Research Development Unit, Loghman Hakim Hospital, Faculty of Medicine, Shahid Beheshti University of Medical Sciences

关键词: Children;    Poisoning;    Opioid;    Naloxone;    Intranasal;   

DOI  :  10.5812/compreped.93342

来源: Kowsarmedical

【 摘 要 】

Background: Opioid poisoning is a common and fatal poisoning in children in our country. Objectives: This study was designed to compare the effects of intranasal (IN) dribbling with intravenous (IV) injection of naloxone in opioid poisoning in Loghman-Hakim Hospital, Tehran, Iran. Methods: This is a prospective, clinical trial study performed on children between the ages of one to 13 years with opioid poisoning from April 2018 to April 2019 compared to IN naloxone 0.01 mg/kg dribbling versus Intravenous naloxone 0.01 mg/kg injection. Patients with nasal congestion, severe poisoning and co-ingestion were excluded. The main outcomes included GCS, response time, respiratory rate, and O 2 saturation. This study was approved by the Ethics Committee of Shahid Beheshti University of Medical Sciences (IR.SBMU.RETECH.REC.1397.258) and was registered with the Iranian Registry of Clinical Trials (www.irct.ir) (IRCT20180226038869N1). Results: A total of 44 patients (22 IV and 22 IN) with a mean age of 38.2 ± 28.8 months in IV and 36.8 ± 19.7 months in the IN naloxone group, 14 methadone and eight opium poisoning in IV and 13 methadone and nine opium poisoning in the IN group. The male/female ratio was 14/8 in both groups. There were no statistically significant differences between the two groups in RR, GCS, and O 2 saturation before naloxone administration. The IV and IN groups had similar average increases in RR, O 2 saturation and GCS after naloxone administration. There was a significant difference in the time of response between the two groups (P < 0.008), 3.9 ± 3 minutes in IV group and 5.9 ± 2.9 minutes in the IN group. No complications were observed in this study. Conclusions: This study showed that Intranasal naloxone is safe, effective, and a well-tolerated needleless method for opioid poisoning in children. Although the time to response was longer in the IN groups, if we add the time needed for IV catheter insertion it seems that the IN route is faster.

【 授权许可】

Unknown