Efficacy of nalmefene antagonizing postoperative respiratory depression in children with congenital heart disease

Objective To evaluate the efficacy of nalmefene antagonizing postoperative respiratory depression in children with congenital heart disease.Methods Sixty ASA Ⅰ or Ⅱ children,aged 3 y-6 y and undergoing congenital heart disease surgery,were included and randomly divided into 3 groups (n=20).All the patients were sent into the cardiac intensive care unit (CICU) after surgery.At 10 min following the patients' vital sign was stable in the CICU,patients in group Ⅰ were administered intravenously with nalmefene 0.25 μg/kg and group Ⅱ were injected intravenously with nalmefene 0.25 μg/kg twice.Patients in group C were not given drug (control group).Mean arterial pressure(MBP),heart rate(HR),pulse oxygen saturation(SpO2) and blood gas analysis before and after administration,during respiratory recovery,duration of extubation,duration of monitoring in the CICU,and adverse effects including nausea,vomiting,fever,restlessness and wound pain were observed.Results Duration of respiratory recovery,extubation,and monitoring in the CICU were (2.9±1.0),(3.6± 1.4) h and (18.5±5.8) h in group C,respectively,(1.8± 0.6),(2.3±0.6) h and(8.2±3.1) h in group Ⅰ,(1.7±0.5),(2.1±0.7) h and (7.9±2.9) h in group Ⅱ.Duration of respiratory recovery,extubation,and monitoring in the CICU were significantly shorter in groups Ⅰ and Ⅱ than in control group (P＜0.05).Incidence of postoperative nausea and vomiting was 15％,5％ and 0％ in groups C,Ⅰ and Ⅱ,respectively,with a lower incidence of postoperative nausea and vomiting in groups Ⅰ and Ⅱ than in group C (P＜0.05).Conclusions Nalmefene is effective and safe for antagonism of postoperative respiratory depression after congenital heart disease surgery in children. Key words: Nalmefene;  Congenital heart disease;  Postoperative respiratory depression