Intranasal naloxone reversal of opioid-induced respiratory depression in opioid-naïve individuals and self-reported daily opioid users
A single Narcan® dose reversed moderate fentanyl- and sufentanil-induced respiratory depression, though effectiveness varied by endpoint and opioid receptor affinity. Rapid V̇E-recovery suggests clinical utility of intranasal naloxone, but delayed and sometimes incomplete recovery of end-tidal pCO2, particularly during exposure to the high-affinity opioid sufentanil, indicating reversal inefficacy and persistence of respiratory instability. Further studies are needed to address optimal naloxone doses and alternative formulations to address high-dose potent opioid threats.
Authors
- M. Niesters
- Monique van Velzen (ORCID: https://orcid.org/0000-0002-0289-6432)
- Elise Sarton (ORCID: https://orcid.org/0009-0007-4403-3815)
- Rutger van der Schrier (ORCID: https://orcid.org/0000-0003-1422-3830)
- Maarten van Lemmen (ORCID: https://orcid.org/0000-0001-8767-1824)
- Erik Olofsen
- Albert Dahan (ORCID: https://orcid.org/0000-0003-3161-3945)
- Zhihua Li (ORCID: https://orcid.org/0000-0003-4820-4603)
- Jeffry Florian
Institutions
- United States Food and Drug Administration (US)
- Center for Drug Evaluation and Research (US)
- Outcomes Research Consortium (US)
- Leiden University Medical Center (NL)
- Centre for Human Drug Research (NL)
- Amsterdam University Medical Centers (NL)
- Nuclear Research and Consultancy Group (NL)
Publication Details
- Journal
- Anesthesiology
- Published
- 2026-02-05
- DOI
- https://doi.org/10.1097/aln.0000000000005931
- Primary Topic
- Neuroscience of respiration and sleep
- Type
- article
- Field-Weighted Citation Impact
- 0.00