The effect of naloxone treatment on opioid-induced side effects: A meta-analysis of randomized and controlled trails

BACKGROUND: To evaluate the effects of naloxone on opioid-induced side effects, the present meta-analysis was constructed. METHODS: Electronic databases including PubMed, EMBASE, and CNKI (China National Knowledge Internet) were used for literature search. Studies on comparison of opioid-side effects between naloxone-treated group and placebo or normal saline-related group were included in the meta-analysis. Heterogeneity analysis was performed with Chi-square and I(2) test. Pooled analysis was based on fixed-effects model, if heterogeneity between the eligible studies was negligible (I(2) < 50%, P > 0.05), otherwise, random-effects model was used. Sensitivity analysis was applied to assess the robustness of the results and publication bias was evaluated by Begg and Egger test. RESULTS: Thirteen studies including 1138 patients were included in the meta-analysis. Pooled analysis indicated that naloxone could significantly reduce the occurrence of pruritus (RR [risk ratio] = 0.252, 95% CI [confidence interval] = 0.137–0.464), nausea (RR = 0.323, 95% CI = 0.245–0.428), and vomiting (RR = 0.338, 95% CI = 0.192–0.593) which were induced by opioids. However, naloxone did not relieve pain (standardized mean difference [SMD] = −0.052, 95% CI = −0.453 to 0.348) and somnolence (RR = 0.561, 95% CI = 0.287 to 1.097) in patients received opioid treatment. Additionally, there were no significant publication bias between the included studies (Begg test, P = 0.602; Egger test, P = 0.388). CONCLUSION: Addition of naloxone might act as an effective treatment for prophylaxis of opioid-induced pruritus, nausea, and vomiting in clinical practice.