{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T16:17:59Z","timestamp":1788020279643,"version":"build-2784847793"},"reference-count":22,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2019,12,2]],"date-time":"2019-12-02T00:00:00Z","timestamp":1575244800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["associationofanaesthetists-publications.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Anaesthesia"],"published-print":{"date-parts":[[2020,6]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:p>\n                    Intrathecal morphine is an analgesic option for major hepatopancreaticobiliary procedures but is associated with a risk of respiratory depression. We hypothesised that a postoperative low\u2010dose naloxone infusion would reduce the incidence of respiratory depression without an increase in pain scores. Patients scheduled for major open hepatopancreaticobiliary surgery and who were receiving 10\u00a0\u03bcg.kg\n                    <jats:sup>\u22121<\/jats:sup>\n                    intrathecal morphine were eligible for inclusion. Patients were allocated randomly to receive a postoperative infusion of naloxone 5\u00a0\u03bcg.kg\n                    <jats:sup>\u22121<\/jats:sup>\n                    .h\n                    <jats:sup>\u22121<\/jats:sup>\n                    (naloxone group) or saline at an identical infusion rate (control group) until the morning after surgery. Clinicians, nursing staff and patients were blinded to group allocation. The primary outcome measure was the incidence of respiratory depression (respiratory rate &lt;\u00a010 breaths.min\n                    <jats:sup>\u22121<\/jats:sup>\n                    and\/or oxygen saturation &lt;\u00a090%). Secondary outcome measures included: arterial partial pressure of carbon dioxide; pain score; requirement for supplemental analgesic; and incidence of nausea and vomiting, pruritus and sedation. In total, data from 95 patients (48 in the naloxone group and 47 in the control group) were analysed. The incidence of respiratory depression was lower in the naloxone group compared with the control group (10\/48 vs. 21\/47 patients, respectively; p\u00a0=\u00a00.037, relative risk 0.47 (95%\n                    <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                    0.25\u20130.87). Maximum pain scores were greater for patients allocated to the naloxone group compared with control (median 5 (95%\n                    <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                    4\u20136) vs. 4 (95%\n                    <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                    2\u20134), respectively; p\u00a0&lt;\u00a00.001). A low\u2010dose naloxone infusion decreases the incidence of respiratory depression following intrathecal morphine administration in patients having major hepatopancreaticobiliary surgery at the expense of a small increase in postoperative pain.\n                  <\/jats:p>","DOI":"10.1111\/anae.14931","type":"journal-article","created":{"date-parts":[[2019,12,2]],"date-time":"2019-12-02T20:48:50Z","timestamp":1575319730000},"page":"747-755","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["The effect of a low\u2010dose naloxone infusion on the incidence of respiratory depression after intrathecal morphine administration for major open hepatobiliary surgery: a randomised controlled trial"],"prefix":"10.1111","volume":"75","author":[{"given":"D.","family":"Cosgrave","sequence":"first","affiliation":[{"name":"Department of Anaesthesia St. Vincent's University Hospital Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Vencken","sequence":"additional","affiliation":[{"name":"Clinical Research Centre University College Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Galligan","sequence":"additional","affiliation":[{"name":"Clinical Research Centre University College Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"McGuinness","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia St. Vincent's University Hospital Dublin Ireland"},{"name":"Department of Anaesthesia the National Maternity Hospital Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"Soukhin","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia Auckland City Hospital Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V.","family":"McMullan","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia Tallaght University Hospital Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Nair","sequence":"additional","affiliation":[{"name":"Liver transplantation and cardiac anaesthesia Kings College Hospital NHS Trust London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Puttappa","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia Addenbrookes Hospital Cambridge University Hospital NHS Trust Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Boylan","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia St. Vincent's University Hospital Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Hussain","sequence":"additional","affiliation":[{"name":"Clinical Research Centre St. Vincent's University Hospital Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N.","family":"Conlon","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia St. Vincent's University Hospital Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"Doran","sequence":"additional","affiliation":[{"name":"Australian and New Zealand Intensive Care Research Centre Monash University Melbourne Vic. Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Nichol","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Medicine St. Vincent's University Hospital Dublin Ireland"},{"name":"Clinical Research Centre St. Vincent's University Hospital Dublin Ireland"},{"name":"Australian and New Zealand Intensive Care Research Centre Monash University Melbourne Vic. Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,12,2]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2003.01.002"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000002386"},{"key":"e_1_2_6_4_1","first-page":"541","article-title":"Effect of analgesic modality on outcome following open liver surgery: a systematic review of postoperative analgesia","volume":"81","author":"Hughes M","year":"2015","journal-title":"Minerva Anestesiologica"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinane.2011.11.005"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000539-200211000-00009"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00540-014-1933-4"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1477-2574.2010.00274.x"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1098-7339(99)90038-X"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1213\/01.ane.0000237291.30499.32"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/hpb.12222"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1155\/2009\/271986"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1213\/01.ane.0000198567.85040.ce"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aen368"},{"key":"e_1_2_6_15_1","first-page":"255","article-title":"High dose intrathecal morphine for major abdominal cancer surgery: a prospective double\u2010blind. 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