Searching for a general anaesthesia protocol for rapid detoxification fromopioids

The technique for ultra rapid opioid detoxification is designed to shorten the detoxification period by precipitating withdrawal by the administration of opioid antagonists such as naloxone or naltrexone. This procedure is pe rformed under deep sedation or general anaesthesia to ensure that the patie nt does not consciously experience the acute withdrawal phase. This strateg y has aroused controversy regarding the risk of sedation or anaesthesia in this situation. In the present study, ultra rapid opioid detoxification was carried out in 12 opiate-addicted patients by infusion of naloxone 4 mg fo r a period of 5 h using controlled ventilation during general anaesthesia, induced and maintained with midazolam, propofol and atracurium. Invasive ca rdiovascular and respiratory monitoring was performed, and withdrawal signs were evaluated using a graduated scale. Anaesthesia was maintained for ano ther hour after the completion of the naloxone infusion. The validity of th is anaesthesia protocol was confirmed by the relative lack of change in the patients' haemodynamic values associated with mild signs of withdrawal.