title: Cardiorespiratory effects of naloxone in children.
abstract: BACKGROUND
  Data on the cardiorespiratory changes and complications following administration of naloxone in children are limited.
  
  
  OBJECTIVE
  To evaluate the cardiorespiratory changes and complications following naloxone treatment in children.
  
  
  METHODS
  The maximal changes in respiratory rate (RR), heart rate (HR), systolic (SBP) and diastolic (DBP) blood pressure, and any complications within 1 and 2 hours following naloxone were tabulated.
  
  
  RESULTS
  One hundred ninety-five children received naloxone over 3 years. The mean +/- SD age was 9.7 +/- 6 years. The total doses of naloxone ranged from 0.01 to 7 mg (0.001-0.5 mg/kg body weight), with a median dose of 0.1 mg. Group 1 patients consisted of 116 (60%) children who were postoperative and had been given naloxone by an anesthesiologist; group 2 patients consisted of 79 (40%) children who received naloxone in the emergency department or pediatric intensive care unit. Patients in group 1 were older: 10.6 +/- 5.3 versus 8.2 +/- 6.7 years (p < 0.006), but received significantly lower doses of naloxone (0.09 +/- 0.2 vs. 1.1 +/- 0.76 mg; p < 0.001). When the entire cohort was evaluated, a significant increase in RR (15 +/- 7 vs. 21 +/- 8 breaths/min; p < 0.001), HR (102 +/- 29 vs.107 +/- 29 beats/min; p < 0.001), SBP (109 +/- 17 vs. 115 +/- 15 mm Hg; p < 0.001), and DBP (56 +/- 10 vs. 60 +/- 13 mm Hg; p < 0.001) within 1 hour following naloxone was noted. When the 2 groups were compared, only the changes in RR were greater in group 2 patients (6.8 +/- 7.9 vs. 4.7 +/- 5 breaths/min; p < 0.001) following naloxone. Systolic hypertension occurred in 33 of 195 (16.9%) of all patients, while diastolic hypertension occurred in 13 (6.6%) of all patients after naloxone. Only the incidence of diastolic hypertension was higher in group 2 compared with group 1 patients following naloxone (16% vs. 2%; p < 0.001). Hypertension resolved spontaneously. One child developed pulmonary edema and required positive pressure ventilation for 22 hours.
  
  
  CONCLUSIONS
  Moderate increases in RR, HR, and BP occur after naloxone administration to children, but development of more serious complications is rare.
authors.affiliation: Michigan State University, Hurley Medical Center, Flint, MI, USA. Rhasan1@hurleymc.com
authors.forename: Rashed A
authors.initials: RA
authors.lastname: Hasan
authors.forename: Amy S
authors.initials: AS
authors.lastname: Benko
authors.forename: Brian M
authors.initials: BM
authors.lastname: Nolan
authors.forename: Julie
authors.initials: J
authors.lastname: Campe
authors.forename: Jenny
authors.initials: J
authors.lastname: Duff
authors.forename: George Y
authors.initials: GY
authors.lastname: Zureikat
mesh_terms: D001794:Blood Pressure / Q000187:drug effects*; D002648:Child; D005260:Female; D006339:Heart Rate / Q000187:drug effects*; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D009270:Naloxone / Q000008:administration & dosage / Q000009:adverse effects*; D009292:Narcotic Antagonists / Q000008:administration & dosage / Q000009:adverse effects*; D012119:Respiration / Q000187:drug effects*; D012189:Retrospective Studies
chemical_list: D009292:Narcotic Antagonists; D009270:Naloxone