• Indian J Med Sci · Feb 2009

    Case Reports

    Naloxone-induced pulmonary edema: a potential cause of postoperative morbidity in laparoscopic donor nephrectomy.

    • Soumya Shankar Nath, Mukesh Tripathi, Chadrakant Pandey, and Bhaskar Rao.
    • Department of Anaesthesiology, Sanjay Gandhi Postgraduate Institue of Medical Sciences, Lucknow, India.
    • Indian J Med Sci. 2009 Feb 1; 63 (2): 72-5.

    AbstractA 28-year-old patient operated for laparoscopic donor nephrectomy (LDN) developed overdose effect of fentanyl leading to poor postoperative recovery. Naloxone (200 microg) treatment was used to reverse fentanyl effects, but it was associated with hypertension. The patient developed pulmonary edema after 2 hours and required overnight mechanical ventilation with positive end-expiratory pressure. Volume overload prescribed in the management of LDN to overcome the immediate poor renal graft functioning probably predisposed this healthy young patient to develop cardiac failure during sympathetic surge associated with naloxone administration. The authors feel that the reversal of overdose effect of opioid by naloxone after intravascular blood volume expansion puts the patient at risk to develop pulmonary edema.

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