Abstract
Introduction. Opioid detoxification is related to unavoidable stress response. Subjective and Objective Opiate Withdrawal Scales provide an indirect quantitative evaluation, whereas cortisol and adrenocorticotropic hormone (ACTH) have been used in some studies as direct markers of stress response. Statistically significant increase of both markers have been reported in studies of opioid detoxification under general anaesthesia and conscious sedation. Method. Randomised double-blind study comparing stress response to Naltrexone induction during rapid opioid detoxification under conscious sedation. Control group received a single 12,5 mg dose, intervention group received an gradual increase from 50 microg to a total of 12,5 mg according to a predefined protocol. Serum concentrations of stress hormones were measured before Naltrexone induction and every 2, 4, and 24 hours after the induction and compared in both control and intervention groups. Result. We report interim results (n = 32). Following Naltrexone induction, levels of both stress hormones incresed significantly in control group and decreased in intervention group - cortisol 850 and 571 nmol/L (p < 0.001), ACTH 34.7 and 19.7 pg/mL (p < 0.05). Conclusions. Gradual increase of Naltrexone dose may significantly reduce stress response to opioid detoxification procedure.
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