Use Of Remifentanil For Reverse Opioid Blockade In A Patient

Abstract

Naltrexone is a pure competitive antagonist at opioid receptors used in the maintenance of abstinence from opioids, alcohol and in rapid opioid detoxification under anaesthesia. Patients on naltrexone therapy may present a challenge in emergency anesthesia and pain management because of very high opioid requirements with several side effects. We report a case where remifentanil was used successfully and uneventfully to overcome this competitive blockade during the anaesthetic management using high doses without accumulation and prolonged recuperation.