• Nancy M Tofil, Kim W Benner, Sarah Jane Faro, and Margaret K Winkler.
• Department of Pediatrics, Division of Critical Care, University of Alabama at Birmingham, Birmingham, AL, USA.
• Pediatr Crit Care Me. 2006 May 1;7(3):252-4.

ObjectiveTo describe the effects of enteral naloxone used to treat opioid-induced constipation in pediatric intensive care patients.DesignRetrospective chart review.SettingPediatric intensive care unit.PatientsTwenty-three patients who received opioid therapy and enteral naloxone in our institution from January 2003 to February 2004 were compared with a randomly sampled control group matched for age, weight, sex, and length of stay who received opioids but had not received enteral naloxone.InterventionsNone.MeasurementsDaily stool output, daily opiate usage, nutrition, adjuvant laxative use, and side effects were assessed.ResultsPatients stayed an average of 5 days (range, 0-13 days) in the pediatric intensive care unit before enteral administration of naloxone was instituted and received it for an average of 9 consecutive days (range, 3-30 days). Mean stool output for study patients before administration of enteral naloxone was 0.14 +/- 0.38 stools per day, whereas after its initiation it was 1.60 +/- 1.14 stools per day (p < .001). However, two patients developed significant opiate withdrawal symptoms after receiving enteral naloxone. The average stool output for control patients was 0.53 +/- 1.21 stools per day.ConclusionsEnteral naloxone may be effective in increasing stool output in opioid-induced constipation but carries the risk of introducing withdrawal symptoms. Further studies are needed to evaluate this agent for opioid-induced constipation in the intensive care unit.

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