title: Does adding low doses of oral naltrexone to morphine alter the subsequent opioid requirements and side effects in trauma patients?
abstract: OBJECTIVE
  The present study aims to assess the influence of ultra-low doses of opioid antagonists on the analgesic properties of opioids and their side effects.
  
  
  METHODS
  In the present randomized, double-blind controlled trial, the influence of the combination of ultra-low-dose naltrexone and morphine on the total opioid requirement and the frequency of the subsequent side effects was compared with that of morphine alone (added with placebo) in patients with trauma in the upper or lower extremities.
  
  
  RESULTS
  Although the morphine and naltrexone group required 0.04 mg more opioids during the study period, there was no significant difference between the opioid requirements of the 2 groups. Nausea was less frequently reported in patients receiving morphine and naltrexone.
  
  
  CONCLUSIONS
  The combination of ultra-low-dose naltrexone and morphine in extremity trauma does not affect the opioid requirements; it, however, lowers the risk of nausea.
authors.affiliation: Department of Emergency Medicine, Imam-Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran, 1419733141. shervinf27@yahoo.com
authors.forename: Shervin
authors.initials: S
authors.lastname: Farahmand
authors.forename: Omid
authors.initials: O
authors.lastname: Ahmadi
authors.forename: Ahmadreza
authors.initials: A
authors.lastname: Dehpour
authors.forename: Patricia
authors.initials: P
authors.lastname: Khashayar
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000698:Analgesia / Q000379:methods*; D000701:Analgesics, Opioid / Q000009:adverse effects / Q000627:therapeutic use*; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005121:Extremities / Q000293:injuries; D005260:Female; D006801:Humans; D008297:Male; D009020:Morphine / Q000009:adverse effects / Q000627:therapeutic use*; D009271:Naltrexone / Q000008:administration & dosage / Q000627:therapeutic use*; D009292:Narcotic Antagonists / Q000008:administration & dosage / Q000627:therapeutic use*; D014947:Wounds and Injuries
chemical_list: D000701:Analgesics, Opioid; D009292:Narcotic Antagonists; D009271:Naltrexone; D009020:Morphine