title: Naloxone for severe traumatic brain injury: a meta-analysis.
abstract: OBJECTIVE
  The efficiency of naloxone for the management of secondary brain injury after severe traumatic brain injury (sTBI) remains undefined. The aim of this study is to evaluate the current evidence regarding the clinical efficiency and safety of naloxone as a treatment for sTBI in mainland China.
  
  
  RESULTS
  A systematic search of the China Biology Medicine disc (CBM), China Science and Technology Journal Database (VIP), China National Knowledge Internet (CNKI), and Wan Fang Database was performed to identify randomized controlled trials (RCTs) of naloxone treatment for patients with sTBI in mainland China. The quality of the included trials was assessed, and the RevMan 5.1 software was employed to conduct this meta-analysis. Nineteen RCTs including 2332 patients were included in this study. The odds ratio (OR) showed statistically significant differences between the naloxone group and the control group (placebo) in terms of mortality at 18 months after treatment (OR, 0.51, 95%CI: 0.38-0.67; p<0.00001), prevalence of abnormal heart rates (OR, 0.30, 95%CI: 0.21-0.43; p<0.00001), abnormal breathing rate (OR, 0.25, 95%CI: 0.17-0.36; p<0.00001) at discharge, the level of intracranial pressure at discharge (OR, 2.00, 95%CI: 1.41-2.83; p = 0.0001), verbal or physical dysfunction rate (OR, 0.65, 95%CI: 0.43-0.98; p = 0.04), and severe disability rate (OR, 0.47, 95%CI: 0.30-0.73; p = 0.0001) at 18 months after the treatment. The mean difference (MD) showed statistically significant differences in awakening time at discharge (MD, -4.81, 95%CI: -5.49 to -4.12; p<0.00001), and GCS at 3 days (MD, 1.00, 95%CI: 0.70-1.30; p<0.00001) and 10 days (MD, 1.76, 95%CI: 1.55-1.97; p<0.00001) after treatment comparing naloxone with placebo group.
  
  
  CONCLUSIONS
  This study indicated that applying naloxone in the early stage for sTBI patients might effectively reduce mortality, control intracranial pressure (ICP), and significantly improve the prognosis.
authors.affiliation: Department of Neurosurgery, Clinical Medical College of Yang Zhou University, Yangzhou, Jiangsu Province, China.
authors.forename: Hengzhu
authors.initials: H
authors.lastname: Zhang
authors.affiliation: Department of Neurosurgery, Clinical Medical College of Yang Zhou University, Yangzhou, Jiangsu Province, China.
authors.forename: Xiaodong
authors.initials: X
authors.lastname: Wang
authors.affiliation: Department of Neurosurgery, Clinical Medical College of Yang Zhou University, Yangzhou, Jiangsu Province, China.
authors.forename: Yuping
authors.initials: Y
authors.lastname: Li
authors.affiliation: Department of Neurosurgery, Chifeng Hospital, Chifeng, Neimenggu Province, China.
authors.forename: Renfei
authors.initials: R
authors.lastname: Du
authors.affiliation: Department of Neurosurgery, The First People's Hospital of Zhenjiang, Zhenjiang, Jiangsu Province, China.
authors.forename: Enxi
authors.initials: E
authors.lastname: Xu
authors.affiliation: Department of Neurosurgery, Clinical Medical College of Yang Zhou University, Yangzhou, Jiangsu Province, China.
authors.forename: Lun
authors.initials: L
authors.lastname: Dong
authors.affiliation: Department of Neurosurgery, Clinical Medical College of Yang Zhou University, Yangzhou, Jiangsu Province, China.
authors.forename: Xingdong
authors.initials: X
authors.lastname: Wang
authors.affiliation: Department of Neurosurgery, Clinical Medical College of Yang Zhou University, Yangzhou, Jiangsu Province, China.
authors.forename: Zhengcun
authors.initials: Z
authors.lastname: Yan
authors.affiliation: Department of Neurosurgery, Clinical Medical College of Yang Zhou University, Yangzhou, Jiangsu Province, China.
authors.forename: Lujun
authors.initials: L
authors.lastname: Pang
authors.affiliation: Department of Neurosurgery, Clinical Medical College of Yang Zhou University, Yangzhou, Jiangsu Province, China.
authors.forename: Min
authors.initials: M
authors.lastname: Wei
authors.affiliation: Department of Neurosurgery, Clinical Medical College of Yang Zhou University, Yangzhou, Jiangsu Province, China.
authors.forename: Lei
authors.initials: L
authors.lastname: She
mesh_terms: D001930:Brain Injuries / Q000188:drug therapy*; D016022:Case-Control Studies; D002986:Clinical Trials as Topic; D006801:Humans; D009270:Naloxone / Q000627:therapeutic use*; D009292:Narcotic Antagonists / Q000627:therapeutic use*
chemical_list: D009292:Narcotic Antagonists; D009270:Naloxone