Evidence map›Paper›PMID 42799176›Full record

ReviewHealth science reports2026

The Role of Ultra-Low-Dose Naloxone as an Additive in Anesthesia and Nerve Block: A Systematic Review.

Mohammadjavad Mehrabanian, Behrang Nooralishahi, Mehdi Dehghani Firoozabadi, Mohammad Sahebjam, Yekta Ghane, Homayoun Pishraft-Sabet, Nazila Heidari, Akbar Shafiee

Abstract readReview
In one paragraph

Review in Health science reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Mohammadjavad MehrabanianTehran Heart Center, Cardiovascular Diseases Research Institute Tehran University of Medical Sciences Tehran Iran.ORCID https://orcid.org/0000-0001-5036-875X
Behrang NooralishahiTehran Heart Center, Cardiovascular Diseases Research Institute Tehran University of Medical Sciences Tehran Iran.ORCID https://orcid.org/0000-0003-1550-153X
Mehdi Dehghani FiroozabadiTehran Heart Center, Cardiovascular Diseases Research Institute Tehran University of Medical Sciences Tehran Iran.ORCID https://orcid.org/0000-0001-6826-6276
Mohammad SahebjamTehran Heart Center, Cardiovascular Diseases Research Institute Tehran University of Medical Sciences Tehran Iran.ORCID https://orcid.org/0000-0002-0907-9435
Yekta GhaneSchool of Medicine, Tehran University of Medical Sciences Tehran Iran.ORCID https://orcid.org/0000-0002-7309-4066
Homayoun Pishraft-SabetSchool of Medicine, Tehran University of Medical Sciences Tehran Iran.ORCID https://orcid.org/0009-0001-0250-729X
Nazila HeidariSchool of Medicine, Iran University of Medical Sciences Tehran Iran.ORCID https://orcid.org/0000-0001-7259-4926
Akbar ShafieeTehran Heart Center, Cardiovascular Diseases Research Institute Tehran University of Medical Sciences Tehran Iran.ORCID https://orcid.org/0000-0001-6912-7788

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background and Aims: In anesthesia and analgesia, opioids alone or in combination with local anesthetics (bupivacaine, lidocaine, and ropivacaine) have been investigated to prolong peripheral nerve blocks. Ultra-low-dose naloxone administration in local anesthetic solutions could lengthen sensory and motor blocks through enhanced opioid effects or direct antagonistic effects on the receptors. We aim to assess the role of ultra-low-dose naloxone as an additive in anesthesia duration, motor, and sensory block duration, visual analog scale (VAS) scores, opioid consumption, and the incidence of postoperative complications. Methods: A systematic search was conducted in PubMed/Medline, Ovid Embase, and Web of Science up to November 23rd, 2023, and 840 records were retrieved and screened. Accordingly, seven randomized controlled trials met the eligibility criteria and were included for data extraction. The National Institute of Health's (NIH) Quality Assessment Tool for Clinical Trials was used for critical appraisal of the studies. Results: The effects of ultra-low-dose naloxone on intravenous regional anesthesia and various nerve blocks (including axillary and supraclavicular brachial plexus, peribulbar, femoral, and intercostal nerve block) were assessed. The administration of naloxone at doses of 100 and 50 ng as an additive to bupivacaine, lidocaine, and ropivacaine was associated with longer postoperative analgesia, prolonged motor and/or sensory block, lower postoperative opioid or analgesic consumption, and lower VAS pain scores in several included studies. Besides, in most studies, postoperative complications did not significantly differ between the groups. Conclusion: The available evidence suggests that ultra-low-dose naloxone may be associated with prolonged postoperative analgesia and, in some studies, longer motor and/or sensory block duration and reduced postoperative opioid consumption. These findings should be interpreted as observations reported by individual studies rather than definitive treatment effects. Although no major safety concerns were identified, the available evidence is insufficient to establish the overall safety or efficacy of ultra-low-dose naloxone.

Indexed as

anesthesianaloxonenerve blocksystematic review

Identifiers

PMID42799176
PMCPMC13614081

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.