title: Naloxone therapy in opioid overdose patients: intranasal or intravenous? A randomized clinical trial.
abstract: BACKGROUND
  This study was designed to compare the effects of intranasal (IN) and intravenous (IV) administration of naloxone in patients who had overdosed on opioids.
  
  
  METHODS
  This randomized clinical trial study was conducted in the Department of Poisoning Emergencies at Noor and Ali Asghar (PBUH) University Hospital. One hundred opioid overdose patients were assigned by random allocation software into two study groups (n = 50). Both groups received 0.4 mg naloxone: one group IN and the other IV. Outcomes included change in the level of consciousness (measured using a descriptive scale and the Glasgow Coma Scale (GCS)), time to response, vital signs (blood pressure, heart rate and respiratory rate), arterial blood O2 saturation before and after naloxone administration, side-effects (agitation) and length of hospital stay.
  
  
  RESULTS
  Patients who had been administered IN naloxone demonstrated significantly higher levels of consciousness than those in the IV group using both descriptive and GCS scales (p < 0.001). There was a significant difference in the heart rate between IN and IV groups (p = 0.003). However, blood pressure, respiratory rate and arterial O2 saturation were not significantly different between the two groups after naloxone administration (p = 0.18, p = 0.17, p = 0.32). There was also no significant difference in the length of hospital stay between the two groups (p = 0.14).
  
  
  CONCLUSIONS
  Intranasal naloxone is as effective as IV naloxone in reversing both respiratory depression and depressive effects on the central nervous system caused by opioid overdose.
authors.affiliation: Isfahan Clinical Toxicology Research Centre, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Ali Mohammad
authors.initials: AM
authors.lastname: Sabzghabaee
authors.affiliation: Isfahan Clinical Toxicology Research Centre, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Nastaran
authors.initials: N
authors.lastname: Eizadi-Mood
authors.affiliation: Department of Anaesthesiology and Intensive Care, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Ahmad
authors.initials: A
authors.lastname: Yaraghi
authors.affiliation: Noor and Ali-Asghar [PBUH] University Hospital, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Samaneh
authors.initials: S
authors.lastname: Zandifar
keywords: intranasal; intravenous; naloxone; opioid; overdose