Should we use naloxone epidurally?

Effects of epidural naloxone on pruritus induced by epidural morphine: a randomized controlled trial

“…10 A morphine-naloxone combination has been used in hundreds patients for the treatment of chronic back pain without reported toxicity. 11 Pruritus was the most common (82% in group M) side effect of morphine in our study. Epidural morphine produces better analgesia than intravenous morphine, but it produces more severe pruritus.…”

What’s new and novel in obstetric anesthesia? Contributions from the 2003 scientific literature

“…Several adjuvant medications, including spinal adenosine 183 and epinephrine 184 and epidural neostigmine 185 and naloxone, 186,187 appear to have beneficial effects in labor. New formulations of existing drugs or drugs within existing categories may also augment neuraxial labor analgesia in the future; Salman et al 188 noted that tramadol encapsulated in mircrospheres and placed into the epidural space had both opioid and non-opioid effects that lasted 21 h. Petrovaara and Kalmari 189 observed that MPV-2426 (fadolmidine), a new selective a 2 -adrenoceptor agonist, induced visceral antinociception equipotent to spinal clonidine and, with dose escalation, had supraspinal effects.…”