Effect of naloxone on anesthesia recovery among patients undergoing total intravenous anesthesia: a retrospective observational study

Opioid use in total intravenous anesthesia (TIVA) poses a risk of postoperative respiratory de-pression due to the residual effects of opioids. Naloxone, an opioid antagonist, can improve anesthesia recovery by stimulating respiratory ventilation and reversing opioid effects. Therefore, this retrospective review of electronic medical records aimed to evaluate the effect of naloxone on anesthesia recovery after TIVA. A total of 304 patients aged 20-100 years with an Ameri-can Society of Anesthesiologists physical status of I-III were assigned to two groups. Group N (naloxone; n=178) received naloxone at the end of surgery, while Group C (control; n=126) did not. After propensity score matching (PSM), 252 patients were allocated to Group C (n=126) or Group N (n=126). The discharge time from the operating room (Dis_OR) and recovery room (RR), Modified Aldrete Score at RR admission and discharge, and incidence of sedation and agitation in the RR were investigated. Before the PSM analysis, the mean Dis_OR was shorter in Group N (11.1 min; 95% confidence interval [CI], 10.4-11.7 min) than in Group C (19.4 min; 95% CI, 18.8-20.0 min) (p<0.001). After the PSM analysis, the mean Dis_OR was shorter in Group N (11.2 min; 95% CI, 10.4-12.0 min) than in Group C (19.4 min; 95% CI, 18.8-20.0 min) (p<0.001). No significant intergroup differences in other parameters were noted before versus after PSM. Nal-oxone was effective to improve anesthesia recovery after TIVA.