The use of enteral naloxone to treat opioid-induced constipation in a pediatric intensive care unit.
OBJECTIVE
To describe the effects of enteral naloxone used to treat opioid-induced constipation in pediatric intensive care patients.


METHODS
Retrospective chart review.


METHODS
Pediatric intensive care unit.


METHODS
Twenty-three patients who received opioid therapy and enteral naloxone in our institution from January 2003 to February 2004 were compared with a randomly sampled control group matched for age, weight, sex, and length of stay who received opioids but had not received enteral naloxone.


METHODS
None.


METHODS
Daily stool output, daily opiate usage, nutrition, adjuvant laxative use, and side effects were assessed.


RESULTS
Patients stayed an average of 5 days (range, 0-13 days) in the pediatric intensive care unit before enteral administration of naloxone was instituted and received it for an average of 9 consecutive days (range, 3-30 days). Mean stool output for study patients before administration of enteral naloxone was 0.14 +/- 0.38 stools per day, whereas after its initiation it was 1.60 +/- 1.14 stools per day (p < .001). However, two patients developed significant opiate withdrawal symptoms after receiving enteral naloxone. The average stool output for control patients was 0.53 +/- 1.21 stools per day.


CONCLUSIONS
Enteral naloxone may be effective in increasing stool output in opioid-induced constipation but carries the risk of introducing withdrawal symptoms. Further studies are needed to evaluate this agent for opioid-induced constipation in the intensive care unit.
Department of Pediatrics, Division of Critical Care, University of Alabama at Birmingham, Birmingham, AL, USA.
Nancy M
NM
Tofil
Kim W
KW
Benner
Sarah Jane
SJ
Faro
Margaret K
MK
Winkler
D000293:Adolescent; D000701:Analgesics, Opioid / Q000008:administration & dosage* / Q000009:adverse effects; D000704:Analysis of Variance; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D003248:Constipation / Q000139:chemically induced / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007223:Infant; D015278:Intensive Care Units, Pediatric; D008297:Male; D009270:Naloxone / Q000627:therapeutic use*; D009292:Narcotic Antagonists / Q000627:therapeutic use*; D012189:Retrospective Studies
D000701:Analgesics, Opioid; D009292:Narcotic Antagonists; D009270:Naloxone