1
UI - 2
TI - Public policy statement on opioid antagonist agent detoxification under sedation or anesthesia (OADUSA) [In Process Citation]
RP - NOT IN FILE
NT - UI - 20560009LA - EngDA - 20001206IS - 1055-0887SB - MCY - UNITED STATESJC - A0YRO - O:099
UR - PM:0011110069
SO - J Addict Dis 2000 ;19(4):109-112
2
UI - 18
AU - Brewer C
AU - Maksoud NA
TI - Opiate detoxification under anesthesia [letter; comment]
MH - adverse effects
MH - Anesthesia
MH - Anesthesia,General
MH - Human
MH - Naltrexone
MH - Narcotic Antagonists
MH - Narcotics
MH - Opioid-Related Disorders
MH - prevention & control
MH - Substance Withdrawal Syndrome
MH - therapeutic use
MH - therapy
RP - NOT IN FILE
NT - UI - 98001622LA - EngRN - 0 (Narcotic Antagonists)RN - 0 (Narcotics)RN - 16590-41-3 (Naltrexone)PT - COMMENTPT - LETTERDA - 19971106IS - 0098-7484SB - ASB - MSB - XCY - UNITED STATESJC - KFREM - 199801RO - M:LC2
UR - PM:0009343457
SO - JAMA 1997 Oct 22 ;278(16):1318
3
UI - 15
AU - Gevirtz C
AU - Subhedar DV
AU - Choi CS
TI - Catecholamine surge in opioid-addicted patients undergoing detoxification under general anesthesia [letter; comment]
MH - Adrenergic alpha-Agonists
MH - Anesthesia
MH - Anesthesia,General
MH - blood
MH - Catecholamines
MH - Clonidine
MH - Human
MH - Naloxone
MH - Narcotic Antagonists
MH - Opioid-Related Disorders
MH - therapeutic use
MH - therapy
RP - NOT IN FILE
NT - UI - 99112562LA - EngRN - 0 (Adrenergic alpha-Agonists)RN - 0 (Catecholamines)RN - 0 (Narcotic Antagonists)RN - 4205-90-7 (Clonidine)RN - 465-65-6 (Naloxone)PT - COMMENTPT - LETTERDA - 19990204IS - 0003-3022SB - ASB - MCY - UNITED STATESJC - 4SGEM - 199904RO - M:LC2
UR - PM:0009915356
SO - Anesthesiology 1999 Jan ;90(1):334-335
4
UI - 9
AU - Gold CG
AU - Cullen DJ
AU - Gonzales S
AU - Houtmeyers D
AU - Dwyer MJ
AD - Department of Anesthesiology and the St. Elizabeth's Comprehensive Addiction Program, St. Elizabeth's Medical Center, Boston, Massachusetts 02135-2997, USA. cgold@tiac.net
TI - Rapid opioid detoxification during general anesthesia: a review of 20 patients [see comments]
AB - BACKGROUND: Opioid addiction therapy includes successful detoxification, rehabilitation, and sometimes methadone maintenance. However, the patient may have physical, mental, and emotional pain while trying to achieve abstinence. A new detoxification technique that incorporates general anesthesia uses a high-dose opioid antagonist to compress detoxification to within 6 h while avoiding the withdrawal. METHODS: After Institutional Review Board approval and detailed informed consent, 20 patients, American Society of Anesthesiologists status I-II, addicted to various opioids underwent anesthesia-assisted rapid opioid detoxification. After baseline hemodynamics and withdrawal scores were obtained, anesthesia was induced. After testing with 0.4 mg intravenous naloxone, 4 mg nalmefene, was infused over 2 to 3 h. After emergence, severity of withdrawal was scored before and after administration of 0.4 mg intravenous naloxone. After 24 h, patients began outpatient follow-up treatment while taking oral naltrexone. RESULTS: All 20 patients were successfully detoxified with no adverse anesthetic events. After the first post-treatment test dose of 0.4 mg naloxone, 13 of 20 patients had no signs of withdrawal and hemodynamic changes were minimal. Withdrawal scores were always very low and similar before and after detoxification. Three of 17 patients (18%) available for follow-up have remained abstinent from opioids since treatment (< or = 18 months). Four other patients are clean after brief relapses. CONCLUSIONS: Anesthesia-assisted opioid detoxification is an alternative to conventional detoxification
MH - Adult
MH - adverse effects
MH - analogs & derivatives
MH - Anesthesia,General
MH - Combined Modality Therapy
MH - drug therapy
MH - Female
MH - Human
MH - Male
MH - Methadone
MH - methods
MH - Middle Age
MH - Monitoring,Physiologic
MH - Naloxone
MH - Naltrexone
MH - Narcotic Antagonists
MH - Opioid-Related Disorders
MH - prevention & control
MH - rehabilitation
MH - Substance Withdrawal Syndrome
MH - Support,Non-U.S.Gov't
MH - therapeutic use
MH - therapy
RP - NOT IN FILE
NT - UI - 20065664LA - EngRN - 0 (Narcotic Antagonists)RN - 16590-41-3 (Naltrexone)RN - 465-65-6 (Naloxone)RN - 55096-26-9 (nalmefene)PT - CLINICAL TRIALPT - JOURNAL ARTICLEDA - 19991230IS - 0003-3022SB - ASB - MCY - UNITED STATESJC - 4SGAA - AuthorEM - 200003RO - M:LC1
UR - PM:0010598605
SO - Anesthesiology 1999 Dec ;91(6):1639-1647
5
UI - 12
AU - Hensel M
AU - Volk T
AU - Kox WJ
AD - Klinik fur Anasthesiologie und operative Intensivmedizin der Charite, Humboldt-Universitat zu Berlin
TI - [Forced opioid detoxification under general anesthesia--a new challenge for anesthetists and intensive care physicians] [see comments]
AB - Treatment of opioid addicts by means of competitive opioid receptor antagonists was developed at the University of Vienna in 1987 by Loimer and co-workers. They compared two withdrawal regimens: The short Opiate withdrawal using a staggered naloxone regimen and the rapid opiate detoxification during general anesthesia by means of high doses of naloxone. Based on the latter concept, various modifications have been developed world-wide using either naloxone or as an alternative, naltrexone, an antagonist available for oral administration only. However, there are considerable objections to opioid detoxification during general anasthesia. The main criticism is based an the supposedly unacceptable high risk:benefit-ratio, the higher costs, the lack of psycho-social support, and the lack of prospective studies. However, first results suggest that rapid detoxification procedures are more successful in decreasing relapse than methods which are based on psychiatric treatment alone. As sympathetic hyperfunction is common in rapid detoxification procedures using high doses of opioid receptor antagonists, it is essential to avoid severe autonomic imbalance with possible subsequent impairment of organ functions. To prevent those disturbances, general anesthesia plays an important role. So far, there is almost no information about such methods in the anesthesiological literature. In this article the clinical relevance of such methods is discussed summarizing both the available literature and our own experience and we conclude that rapid opioid detoxification under general anesthesia is a safe and efficient method to suppress withdrawal symptoms. This treatment may be of benefit in patients who particularly suffer from severe withdrawal symptoms and who have failed repeatedly to complete conventional withdrawal
MH - administration & dosage
MH - Anesthesia,General
MH - Anesthesiology
MH - Comparative Study
MH - drug therapy
MH - English Abstract
MH - Human
MH - Intensive Care
MH - Metabolic Detoxication,Drug
MH - methods
MH - Naloxone
MH - Naltrexone
MH - Narcotic Antagonists
MH - Narcotics
MH - Opioid-Related Disorders
MH - pharmacokinetics
MH - Prospective Studies
MH - Substance Withdrawal Syndrome
MH - therapeutic use
RP - NOT IN FILE
NT - UI - 99300803LA - GerRN - 0 (Narcotic Antagonists)RN - 0 (Narcotics)RN - 465-65-6 (Naloxone)PT - JOURNAL ARTICLEPT - REVIEWPT - REVIEW, TUTORIALDA - 19990709IS - 0939-2661SB - MCY - GERMANYJC - A4CAA - AuthorEM - 199909
UR - PM:0010372215
SO - Anasthesiol Intensivmed Notfallmed Schmerzther 1999 May ;34(5):261-268
6
UI - 16
AU - Kienbaum P
AU - Thurauf N
AU - Michel MC
AU - Scherbaum N
AU - Gastpar M
AU - Peters J
AD - Abteilung fur Anasthesiologie und Intensivmedizin, Universitat GH Essen, Germany. peter.kienbaum@uni-essen.de
TI - Profound increase in epinephrine concentration in plasma and cardiovascular stimulation after mu-opioid receptor blockade in opioid- addicted patients during barbiturate-induced anesthesia for acute detoxification [see comments]
AB - BACKGROUND: Acute displacement of opioids from their receptors by administration of large doses of opioid antagonists during general anesthesia is a new approach for detoxification of patients addicted to opioids. The authors tested the hypothesis that mu-opioid receptor blockade by naloxone induces cardiovascular stimulation mediated by the sympathoadrenal system. METHODS: Heart rate, cardiac index, and intravascular pressures were measured in 10 patients addicted to opioids (drug history; mean +/- SD, 71 +/- 51 months) during a program of methadone substitution (96 +/- 57 mg/day). Cardiovascular variables and concentrations of catecholamine in plasma were measured in the awake state, during methohexital-induced anesthesia (dose, 74 +/- 44 microg x kg(-1) x min(-1)) before administration of naloxone, and repeatedly during the first 3 h of mu-opioid receptor blockade. Naloxone was administered initially in an intravenous dose of 0.4 mg, followed by incremental bolus doses (0.8, 1.6, 3.2, and 6.4 mg) at 15- min intervals until a total dose of 12.4 mg had been administered within 60 min; administration was then continued by infusion (0.8 mg/h). RESULTS: Concentration of epinephrine in plasma increased 30- fold (15 +/- 9 to 458 +/- 304 pg/ml), whereas concentration of norepinephrine in plasma only increased to a minor extent (76 +/- 44 to 226 +/- 58 pg/ml, P < 0.05). Cardiac index increased by 74% (2.7 +/- 0.41 to 4.7 +/- 1.7 min(-1) x m(-2)), because of increases in heart rate (89 +/- 16 to 108 +/- 17 beats/min) and stroke volume (+44%), reaching maximum 45 min after the initial injection of naloxone. In parallel, systemic vascular resistance index decreased (-40%). Systolic arterial pressure significantly increased (113 +/- 16 to 138 +/- 16 mmHg), whereas diastolic arterial pressure did not change. CONCLUSIONS: Despite barbiturate-induced anesthesia, acute mu-opioid receptor blockade in patients addicted to opioids induces profound epinephrine release and cardiovascular stimulation. These data suggest that long- term opioid receptor stimulation changes sympathoadrenal and cardiovascular function, which is acutely unmasked by mu-opioid receptor blockade. Because of the attendant cardiovascular stimulation, acute detoxification using naloxone should be performed by trained anesthesiologists or intensivists
MH - Adult
MH - Anesthesia
MH - Anesthesia,General
MH - Anesthetics,Intravenous
MH - antagonists & inhibitors
MH - blood
MH - Chromatography,High Pressure Liquid
MH - drug effects
MH - drug therapy
MH - Epinephrine
MH - Female
MH - Hemodynamics
MH - Human
MH - Infusions,Intravenous
MH - Male
MH - Methadone
MH - methods
MH - Methohexital
MH - Naloxone
MH - Narcotic Antagonists
MH - Norepinephrine
MH - Opioid-Related Disorders
MH - pharmacology
MH - Receptors,Opioid,mu
MH - Support,Non-U.S.Gov't
MH - therapeutic use
RP - NOT IN FILE
NT - UI - 98266710LA - EngRN - 0 (Anesthetics, Intravenous)RN - 0 (Narcotic Antagonists)RN - 0 (Receptors, Opioid, mu)RN - 18652-93-2 (Methohexital)RN - 465-65-6 (Naloxone)RN - 51-41-2 (Norepinephrine)RN - 51-43-4 (Epinephrine)PT - CLINICAL TRIALPT - JOURNAL ARTICLEDA - 19980616IS - 0003-3022SB - ASB - MCY - UNITED STATESJC - 4SGAA - AuthorEM - 199808RO - M:LC2
UR - PM:0009605673
SO - Anesthesiology 1998 May ;88(5):1154-1161
7
UI - 5
AU - Kienbaum P
AU - Scherbaum N
AU - Thurauf N
AU - Michel MC
AU - Gastpar M
AU - Peters J
AD - Abteilung fur Anasthesiologie und Intensivmedizin, Universitat GH Essen, Germany
TI - Acute detoxification of opioid-addicted patients with naloxone during propofol or methohexital anesthesia: a comparison of withdrawal symptoms, neuroendocrine, metabolic, and cardiovascular patterns
AB - OBJECTIVE: Mu-Opioid receptor blockade during general anesthesia is a new treatment for detoxification of opioid addicted patients. We assessed catecholamine plasma concentrations, oxygen consumption, cardiovascular variables, and withdrawal symptoms after naloxone and tested the hypothesis that variables are influenced by the anesthetic administered during detoxification. DESIGN: Prospective randomized clinical study. SETTING: Intensive care unit of a university hospital and psychiatric ward. PATIENTS: Twenty-five mono-opioid addicted patients with mild to moderate systemic disease (ASA II classification) in a methadone substitution program. INTERVENTION: General anesthesia with either propofol (129+/-7 microg x kg(-1) x min(-1), mean +/- SEM) or methohexital (74+/-14 microg x kg(-1). min(-1)), mu-opioid receptor blockade by naloxone in a stepwise fashion (increasing doses of 0.4 mg, 0.8 mg, 1.6 mg, 3.2 mg, and 6.4 mg at 15 min intervals followed by 0.8 mg x hr(-1) for 24 hrs) and naltrexone 50 mg x day(-1) orally for > or =4 wks. Clonidine was started 180 mins after the first naloxone dose and its infusion rate was individually adjusted to mitigate withdrawal symptoms during weaning and after extubation. MEASUREMENTS AND MAIN RESULTS: During propofol and methohexital anesthesia, naloxone induced a 30-fold increase in epinephrine and a significant three-fold increase in norepinephrine plasma concentrations without a significant difference between groups. This increase in catecholamine plasma concentrations was associated with increased oxygen consumption and marked cardiovascular stimulation with both anesthetics, as shown by increased cardiac index, heart rate, and systolic atrial pressure whereas diastolic pressure remained unchanged. Patients receiving propofol could be extubated significantly earlier after discontinuation of the anesthetics. Although the maximum degree of withdrawal symptoms (Short Opioid Withdrawal Scale) on the day after detoxification was similar with both anesthetics, subsequent withdrawal symptoms decreased significantly more rapidly after propofol anesthesia. CONCLUSIONS: Naloxone treatment, in opioid-addicted patients, induced a marked increase in catecholamine plasma concentrations, metabolism, and cardiovascular stimulation during anesthesia with both propofol and methohexital. Although both anesthetics appear suitable for detoxification treatment, the use of propofol is associated with earlier extubation and, surprisingly, a shortened period of long-term withdrawal symptoms during detoxification
MH - Adult
MH - Anesthesia,General
MH - Anesthetics,Intravenous
MH - blood
MH - Catecholamines
MH - Comparative Study
MH - drug therapy
MH - Female
MH - Human
MH - Male
MH - Methadone
MH - Methohexital
MH - Middle Age
MH - Naloxone
MH - Narcotic Antagonists
MH - Narcotics
MH - Opioid-Related Disorders
MH - Propofol
MH - Prospective Studies
MH - rehabilitation
MH - Substance Withdrawal Syndrome
MH - Support,Non-U.S.Gov't
MH - therapeutic use
RP - NOT IN FILE
NT - UI - 20267265LA - EngRN - 0 (Anesthetics, Intravenous)RN - 0 (Catecholamines)RN - 0 (Narcotic Antagonists)RN - 0 (Narcotics)RN - 18652-93-2 (Methohexital)RN - 2078-54-8 (Propofol)RN - 465-65-6 (Naloxone)RN - 76-99-3 (Methadone)PT - CLINICAL TRIALPT - JOURNAL ARTICLEPT - RANDOMIZED CONTROLLED TRIALDA - 20000525IS - 0090-3493SB - ASB - MCY - UNITED STATESJC - DTFAA - AuthorEM - 200007
UR - PM:0010809268
SO - Crit Care Med 2000 Apr ;28(4):969-976
8
UI - 11
AU - Kirsner K
AU - Biddle C
AD - Anderson Hospital, Houston, Texas, USA
TI - AANA Journal course: update for nurse anesthetists-accelerated detoxification from opioid addiction under anesthesia: the Midas touch or the emperor's new clothes?
AB - Opioids are highly addictive substances that include natural and synthetic chemicals that mimic the effects of morphine or bind to morphine receptor sites. Traditional assisted withdrawal is a process that takes several days to weeks and is associated with a host of painful and difficult symptoms. Recently, accelerated detoxification using opioid antagonists administered while the patient is anesthetized has been promoted, with centers proliferating nationwide. Published studies of rapid detoxification under anesthesia are highly variable in quality and control, and long-term outcome data are incomplete. Well- controlled, carefully designed studies are needed to appropriately assess the efficacy, safety, and cost-effectiveness of the approach
MH - Anesthesia,General
MH - drug therapy
MH - Human
MH - methods
MH - Nurse Anesthetists
MH - nursing
MH - Opioid-Related Disorders
MH - Time Factors
RP - NOT IN FILE
NT - UI - 99417924LA - EngPT - JOURNAL ARTICLEPT - REVIEWPT - REVIEW, TUTORIALDA - 19990929IS - 0094-6354SB - NCY - UNITED STATESJC - 02PAA - AuthorEM - 199912
UR - PM:0010488300
SO - AANA J 1999 Jun ;67(3):279-285
9
UI - 7
AU - Laheij RJ
AU - Krabbe PF
AU - de Jong CA
TI - Rapid heroin detoxification under general anesthesia [letter]
MH - administration & dosage
MH - Anesthesia,General
MH - Heroin Dependence
MH - Human
MH - Naltrexone
MH - Narcotic Antagonists
MH - rehabilitation
MH - therapeutic use
RP - NOT IN FILE
NT - UI - 20166515LA - EngRN - 0 (Narcotic Antagonists)RN - 16590-41-3 (Naltrexone)PT - LETTERDA - 20000309IS - 0098-7484SB - ASB - MSB - XCY - UNITED STATESJC - KFREM - 200005
UR - PM:0010703775
SO - JAMA 2000 Mar 1 ;283(9):1143
10
UI - 13
AU - Peters J
AU - Kienbaum P
TI - [Opioid detoxification under anesthesia: new scientific territory or established methods? (editorial; comment)]
MH - administration & dosage
MH - Anesthesia,General
MH - drug therapy
MH - Human
MH - Metabolic Detoxication,Drug
MH - methods
MH - Narcotic Antagonists
MH - Narcotics
MH - Opioid-Related Disorders
MH - pharmacokinetics
MH - Substance Withdrawal Syndrome
MH - Substance-Related Disorders
MH - therapeutic use
MH - therapy
RP - NOT IN FILE
NT - UI - 99300802LA - GerRN - 0 (Narcotic Antagonists)RN - 0 (Narcotics)PT - COMMENTPT - EDITORIALDA - 19990709IS - 0939-2661SB - MCY - GERMANYJC - A4CEM - 199909
UR - PM:0010372214
SO - Anasthesiol Intensivmed Notfallmed Schmerzther 1999 May ;34(5):259-260
11
UI - 14
AU - Pfab R
AU - Hirtl C
AU - Zilker T
AD - Toxikologische Abteilung, Medizinische Klinik, Munchen, West Germany. rudi.pfab@t-online.de
TI - Opiate detoxification under anesthesia: no apparent benefit but suppression of thyroid hormones and risk of pulmonary and renal failure
AB - INTRODUCTION: The new technique for opiate detoxification using anesthesia and high, repetitive doses of opiate-antagonists claims to detoxify addicts without withdrawal symptoms within 24-48 hours. We studied the method with 12 opiate addicts (5 L-polamidone, 4 dihydrocodeine, 3 heroin), using general anesthesia and the antagonists naloxone 0.5 mg/kg and naltrexone > 150 mg. Objective and subjective withdrawal symptoms were measured until urine was free of drugs and patients had no withdrawal symptoms. Thyroid hormones were measured before, during, and after the anesthesia period. RESULTS: All patients had moderate to severe opiate withdrawal symptoms. No detoxification was finished within 48 hours. The dihydrocodeine subjects were compared with conventionally detoxified controls; no difference was seen. The method suppressed thyroid hormones TT3, TT4, and TSH. The study was terminated because of side effects: 1 pulmonary failure and 2 renal failures. All patients survived without sequelae. CONCLUSION: There is no obvious benefit from this method, whereas the risks are high
MH - Adult
MH - adverse effects
MH - analogs & derivatives
MH - Anesthesia
MH - blood
MH - Codeine
MH - etiology
MH - Female
MH - Heroin Dependence
MH - Human
MH - Kidney Failure,Acute
MH - Male
MH - Methadone
MH - Naloxone
MH - Naltrexone
MH - Narcotic Antagonists
MH - Narcotics
MH - Opioid-Related Disorders
MH - physiopathology
MH - prevention & control
MH - Respiratory Insufficiency
MH - Substance Withdrawal Syndrome
MH - therapeutic use
MH - therapy
MH - Thyroid Hormones
RP - NOT IN FILE
NT - UI - 99177885LA - EngRN - 0 (Narcotic Antagonists)RN - 0 (Narcotics)RN - 0 (Thyroid Hormones)RN - 125-28-0 (dihydrocodeine)RN - 16590-41-3 (Naltrexone)RN - 465-65-6 (Naloxone)RN - 76-57-3 (Codeine)RN - 76-99-3 (Methadone)PT - CLINICAL TRIALPT - JOURNAL ARTICLEDA - 19990330IS - 0731-3810SB - ASB - MCY - UNITED STATESJC - KANAA - AuthorEM - 199906
UR - PM:0010078159
SO - J Toxicol Clin Toxicol 1999 ;37(1):43-50
12
UI - 22
AU - Presslich O
AU - Loimer N
AU - Lenz K
AU - Schmid R
AD - Department of Intensive Care, Psychiatric University Clinic, Vienna, Austria
TI - Opiate detoxification under general anesthesia by large doses of naloxone
AB - For opiate detoxification 6 volunteer opiate addicts were intravenously administered 10 mg naloxone within one hour while under barbiturate anesthesia. During administration of naloxone none of the patients demonstrated significant changes in the hemodynamic parameters of heart rate, mean arterial pressure, cardiac index, peripheral resistance or in the oxygen saturation. After patients awoke from anesthesia, they experienced no or only minimal withdrawal symptoms. Possible explanations for the suppression of withdrawal symptoms are discussed
MH - administration & dosage
MH - Adult
MH - Anesthesia
MH - Anesthesia,General
MH - Blood Pressure
MH - diagnostic use
MH - drug effects
MH - Heart Rate
MH - Human
MH - Intensive Care
MH - Male
MH - Metabolic Detoxication,Drug
MH - Naloxone
MH - Opioid-Related Disorders
MH - Oxygen Consumption
MH - prevention & control
MH - Substance Withdrawal Syndrome
MH - therapeutic use
MH - Thiopental
MH - Vascular Resistance
RP - NOT IN FILE
NT - UI - 90096216LA - EngRN - 465-65-6 (Naloxone)RN - 76-75-5 (Thiopental)PT - JOURNAL ARTICLEDA - 19900208IS - 0731-3810SB - ASB - MCY - UNITED STATESJC - KANAA - AuthorEM - 199004
UR - PM:0002600989
SO - J Toxicol Clin Toxicol 1989 ;27(4-5):263-270
13
UI - 17
AU - Solomont JH
TI - Opiate detoxification under anesthesia [letter; comment]
MH - Anesthesia
MH - Human
MH - Opioid-Related Disorders
MH - rehabilitation
MH - standards
MH - Substance Abuse Treatment Centers
RP - NOT IN FILE
NT - UI - 98001623LA - EngPT - COMMENTPT - LETTERDA - 19971106IS - 0098-7484SB - ASB - MSB - XCY - UNITED STATESJC - KFREM - 199801RO - M:LC2
UR - PM:0009343458
SO - JAMA 1997 Oct 22 ;278(16):1318
14
UI - 21
AU - Stephenson J
TI - Experts debate merits of 1-day opiate detoxification under anesthesia [news] [see comments]
MH - Anesthesia
MH - Anesthesia,General
MH - Human
MH - Naltrexone
MH - Narcotic Antagonists
MH - Opioid-Related Disorders
MH - prevention & control
MH - rehabilitation
MH - Substance Abuse Treatment Centers
MH - Substance Withdrawal Syndrome
MH - therapeutic use
MH - trends
RP - NOT IN FILE
NT - UI - 97163335LA - EngRN - 0 (Narcotic Antagonists)RN - 16590-41-3 (Naltrexone)PT - NEWSDA - 19970213IS - 0098-7484SB - ASB - MSB - XCY - UNITED STATESJC - KFREM - 199704RO - M:LC2
UR - PM:0009010155
SO - JAMA 1997 Feb 5 ;277(5):363-364
15
UI - 3
AU - Streel E
AU - Bredas P
AU - Dan B
AU - Hanak C
AU - Pelc I
AU - Verbanck P
AD - CHU Brugmann (Universite Libre de Bruxelles), Institut de Psychiatrie, Clinique d'Alcoologie & Toxicomanies, Brussels, Belgium. manu.streel@chu-brugmann.be
TI - Previous anesthesia can temporarily overshadow the expression of a withdrawal syndrome in opiate dependent rats [In Process Citation]
AB - We hypothesized that induction of opiate antagonist-precipitated withdrawal under anesthesia can decrease the expression of later withdrawal signs. Three groups of morphine-dependent rats were compared in different experimental conditions of withdrawal precipitation using naloxone. We showed that anesthesia can temporarily overshadow the expression of withdrawal signs, but that some signs can be delayed and increased in intensity. This can be explained by a parallel and temporary effect of anesthesia on arousal and pain threshold. This carries important implications on the use of anesthesia in detoxification procedures
RP - NOT IN FILE
NT - UI - 20555589LA - EngDA - 20001205IS - 0024-3205SB - MSB - XCY - ENGLANDJC - L62AA - AUTHORRO - O:099
UR - PM:0011106003
SO - Life Sci 2000 Oct 27 ;67(23):2883-2887
16
UI - 4
AU - Whittington A
AU - Collins ED
AU - Kleber HD
AU - Gold G
AU - Cullen DJ
AU - Gonzales S
AU - Houtmeyers D
AU - Dwyer MJ
TI - Rapid opioid detoxification during general anesthesia: is death not a significant outcome? [In Process Citation]
RP - NOT IN FILE
NT - UI - 20500789LA - EngDA - 20001109IS - 0003-3022SB - ASB - MCY - UNITED STATESJC - 4SGRO - O:099
UR - PM:0011046233
SO - Anesthesiology 2000 Nov ;93(5):1363-1364
17
UI - 6
AU - Wilson LB
AU - DeMaria PA
AU - Kane HL
AU - Reining KM
AD - Thomas Jefferson University Hospital, Philadelphia, PA, USA
TI - Anesthesia-assisted rapid opiate detoxification: a new procedure in the postanesthesia care unit
AB - Heroin detoxification by anesthesia-assisted rapid opiate detoxification (AAROD) can be achieved in approximately 1 hour using intravenous administration of midazolam, propofol, and naloxone. Opiate dependence and detoxification techniques are reviewed. Important aspects of patient care and perianesthesia nursing are described using a case study. To assist in caring for the patient undergoing anesthesia- assisted rapid opiate detoxification, the perianesthesia nurse should understand the methodology and controversy of this new procedure
MH - Adult
MH - Anesthesia,General
MH - Anesthetics,Intravenous
MH - Case Report
MH - drug therapy
MH - Heroin Dependence
MH - Human
MH - Male
MH - methods
MH - Midazolam
MH - Naloxone
MH - Narcotic Antagonists
MH - nursing
MH - Perioperative Care
MH - Postanesthesia Nursing
MH - Propofol
MH - Substance Withdrawal Syndrome
MH - therapeutic use
RP - NOT IN FILE
NT - UI - 20209877LA - EngRN - 0 (Anesthetics, Intravenous)RN - 0 (Narcotic Antagonists)RN - 2078-54-8 (Propofol)RN - 465-65-6 (Naloxone)RN - 59467-70-8 (Midazolam)PT - JOURNAL ARTICLEPT - REVIEWPT - REVIEW, TUTORIALDA - 20000731IS - 1089-9472SB - NCY - UNITED STATESJC - CKXAA - AuthorEM - 200010
UR - PM:0010745790
SO - J Perianesth Nurs 1999 Aug ;14(4):207-212