From: The effect of opioids on gastrointestinal function in the ICU
Clinical trials | Study design | Population | Group | Study goal | Conclusion |
---|---|---|---|---|---|
Liu et al. [79] | RCT | 9 OIC patients | NTX (n = 6) vs placebo (n = 3) | To evaluate the effect of low doses of NTX on constipation and analgesia | Bowel frequency improved but reversal of analgesia also occurred |
Meissner et al. [76] | RCT | 84 mechanically ventilated patients received intravenous infusion of fentanyl | NTX (n = 38) vs placebo (n = 43) | To study the effect of NTX on the gastric tube reflux, the occurrence of pneumonia, and the time to first defecation | The administration of NTX was effective to reduce gastric tube reflux and frequency of pneumonia, but the first defecation in the two groups did not differ |
Arpino et al. [78] | RS | 26 OIC patients in the ICU received opioids at least 48Â h prior to NTX | Comparison between before and after NTX administration | To assess the safety of NTX in the ICU | The administration of NTX was not associated with changes in sedation score, vital signs, fentanyl dose, midazolam dose or propofol dose |
Gibson et al. [77] | RS | 16 OIC patients received scheduled doses of opioids for pain control in the MICU | Before and after during NTX treatment | To evaluate the efficacy and safety of NTX before and after during naloxone treatment | NTX appeared to be effective and safe for the treatment of OIC in the MICU. NTX had no reversal of analgesic |
Merchan et al. [81] | RS | 100 OIC patients in the MICU | NTX (n = 52) vs MNTX (n = 48) | To assess the effectiveness and safety of NTX and MNTX for the treatment of OIC | MNTX and NTX appear to be effective and safe for the treatment of OIC. The median times to first BM for NTX and MNTX were 30 and 24 h (P = 0.165) |
Patel et al. [73] | RCT | 84 OIC patients in the ICU with opioid analgesics for at least 24 h | MNTX (n = 41) vs placebo (n = 43) | To investigate whether MNTX alleviates OIC in critically ill patients | There was no evidence to support the addition of MNTX to regular laxatives for the treatment of OIC in the ICU |
Sawh et al. [85] | RS | 15 OIC patients in the ICU | MNTX (n = 7) vs conventional rescue therapy (n = 8) to treat the OIC in the ICU | To compare the effect of MNTX and conventional rescue therapy in the ICU | MNTX was effective in the treatment of OIC patients |
Masding et al. [86] | ROS | 827 patients in the cardiothoracic ICU | NA | the prevalence of OIC in a large cardiothoracic ICU and the use of naloxegol | Nearly 20% of ICU patients had OIC and use of naloxegol could reduce the prevalence of OIC |
Phase 3 [87] | RCT | 350 ICU patients received opioids at least 48Â h hours | Polyethylene glycol vs naloxegol | To investigate whether naloxegol is superior to osmotic laxatives for refractory constipation in ICU patients | The study had withdrawn |