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December 10, 1982

Possible Dangers of Naloxone Use-Reply

Author Affiliations

Rocky Mountain Poison Center Denver

JAMA. 1982;248(22):2973. doi:10.1001/jama.1982.03330220018022

In Reply.—  If the literature concerning the alleged adverse effects of naloxone is read carefully, a consistent pattern can be seen. The cases are all anecdotal reports of postoperative patients who have experienced substantial medical complications some minutes after the administration of naloxone during their emergence from anesthesia. The patients, for the most part, underwent major surgery that required large amounts of narcotics and multiple other agents for adequate anesthesia and analgesia. The temporal sequence of events after surgery may implicate naloxone as a causative agent, but the association is weak at best. The conclusion that can be drawn from these cases is only that naloxone should be used judiciously in patients emerging from anesthesia.The use of naloxone as both a diagnostic and therapeutic agent in unconscious patients in the emergency department is not analogous to its use after surgery. When naloxone has been used in acutely poisoned patients,