PubMed Health⌕ Search

PubMed · 12362827

[Opioid detoxication under general anesthesia].

Abstract

Antagonist-precipitated opioid detoxification under general anaesthesia has been used extensively since its introduction in 1988. The use of antagonists was believed to shorten the detoxification period. Administration to opioid dependents is followed by a violent activation of the adrenergic system, which results in the development of an acute withdrawal syndrome in the patient. This is usually treated with clonidine. To reduce the subjective discomfort, the procedure is conducted under anaesthesia. From the existing literature, one may conclude that despite more than ten years of development there is currently no sufficient evidence of the effectiveness of antagonist-precipitated opioid detoxification under general anaesthesia conducted under modern anaesthesiological management. Randomised, clinical trials are necessary to document the advantages of this detoxification method as compared to conventional treatment.

Explore related subjects

Keep this discovery

Explore connections, maps & timelines

BibTeXRIS

Mikhail J Zemtsovski, Oleg Trosko, Henrik Schmidt. 2002-09-02. [Opioid detoxication under general anesthesia].. https://pubmed.ncbi.nlm.nih.gov/12362827/

Cite the original work for its findings. Save a collection to share your selection of sources.

KEEP EXPLORING

Related citations

Stereoselective pharmacokinetics of ketamine and norketamine after racemic ketamine or S-ketamine administration during isoflurane anaesthesia in Shetland ponies.

BACKGROUND: The arterial pharmacokinetics of ketamine and norketamine enantiomers after racemic ketamine or S-ketamine i.v. administration were evaluated in seven gelding ponies in a crossover study (2-month interval). METHODS: Anaesthesia was induced with isoflurane in oxygen via a face-mask and then maintained at each pony's individual MAC. Racemic ketamine (2.2 mg kg(-1)) or S-ketamine (1.1 mg kg(-1)) was injected in the right jugular vein. Blood samples were collected from the right carotid artery before and at 1, 2, 4, 8, 16, 32, 64, and 128 min after ketamine administration. Ketamine and norketamine enantiomer plasma concentrations were determined by capillary electrophoresis. Individual R-ketamine and S-ketamine concentration vs time curves were analysed by non-linear least square regression two-compartment model analysis using PCNonlin. Plasma disposition curves for R-norketamine and S-norketamine were described by estimating AUC, C(max), and T(max). Pulse rate (PR), respiratory rate (R(f)), tidal volume (V(T)), minute volume ventilation (V(E)), end-tidal partial pressure of carbon dioxide (PE'(CO(2))), and mean arterial blood pressure (MAP) were also evaluated. RESULTS: The pharmacokinetic parameters of S- and R-ketamine administered in the racemic mixture or S-ketamine administered separately did not differ significantly. Statistically significant higher AUC and C(max) were found for S-norketamine compared with R-norketamine in the racemic group. Overall, R(f), V(E), PE'(CO(2)), and MAP were significantly higher in the racemic group, whereas PR was higher in the S-ketamine group. CONCLUSIONS: Norketamine enantiomers showed different pharmacokinetic profiles after single i.v. administration of racemic ketamine in ponies anaesthetised with isoflurane in oxygen (1 MAC). Cardiopulmonary variables require further investigation.

Anesthesia, General↗