Negative pressure pulmonary edema following naloxone administration in a patient with fentanyl-induced respiratory depression.

Sept 2010

Horng HC, Ho MT, Huang CH, Yeh CC, Cherng CH.

Source

Division of Anesthesiology, Taichung Armed Forces General Hospital, Taichung, Taiwan, Republic of China.

Abstract

Naloxone is commonly used to reverse narcotic intoxication. However, its use is not entirely free of hazards. For instance, pulmonary edema (PE) has been reported to arise with the mechanism of over-sympathetic discharge caused by release of cat-echolamine or central neurogenetic responses to narcotic reversal. Here, we report a healthy young patient who, after undergoing an uneventful uvulopalatopharyngo-plasty for obstructive sleep apnea hypopnea syndrome, developed PE following administration of naloxone. Fentanyl-induced respiratory depression was found during anesthesia emergence and thus naloxone was indicated for reversal. Unfortunately, upper airway obstruction-induced negative pressure PE occurred following naloxone administration. From this case, we suggest that a patent airway should be ascertained before naloxone administration for treating narcotic-induced respiratory depression.

Elsevier

Naloxone-induced pulmonary edema : Case report with review of the literature and critical evaluation

Feb 2012

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[Article in German]

Lassen CL, Zink W, Wiese CH, Graf BM, Wiesenack C.

Source

Klinik für Anästhesiologie, Universitätsklinikum Regensburg, Regensburg, Deutschland, christoph.lassen@klinik.uni-regensburg.de.

Abstract

A case of pulmonary edema after the administration of naloxone for laparoscopic splenectomy is reported. Previous reports of naloxone-induced pulmonary edema are listed and reviewed. The clinical course is compared to other forms of non-cardiogenic pulmonary edema. Uncertainty remains about the underlying pathophysiological process and the true impact of naloxone on the development of pulmonary edema.

PubMed