Lactulose Versus Naloxone for Opioid-Induced Constipation in the Poisoning Intensive Care Unit

INTRODUCTION: Constipation caused by opioids (OIC) is prevalent among critically poisoned patients and can result in complications that prolong hospitalization and, in rare cases, cause bowel perforation. The aim of this research is to evaluate the safety and efficacy of lactulose and naloxone in treating OIC in the intensive care unit (ICU) for poisoning.
METHODS: This study was a randomized and double-blind clinical trial on patients with opioid poisoning who suffered from constipation for 14 months. The patients were divided into two groups, one group receiving lactulose (30 cc daily) and the other receiving naloxone (8 mg Three times a day). The parameters of age, gender, type of opioid used, APACHE II, GCS score, defecation time and a number of laboratory variables were recorded. All data was collected and analyzed by SPSS software.
RESULTS: Out of the participants in the lactulose group, 85.37% were males and 14.63% were females. In the naloxone group, 94.9% were males and 5.1% were females. The average age in the lactulose group was 44±16.2 years, while in the naloxone group it was 48.13±19.1 years. The average defecation time was 30.8±23.1 hours in the naloxone group and 25±11.5 hours in the lactulose group. Six patients (15%) in the naloxone group experienced treatment failure. Symptoms of withdrawal syndrome were experienced by 15 patients (39.5%) in naloxone group.
DISCUSSION AND CONCLUSION: The evidence suggests that lactulose is a superior choice because it does not carry the risk of withdrawal syndrome or treatment ineffectiveness.