Intranasal Naloxone Reversal of Opioid-induced Respiratory Depression in Opioid-naive Individuals and Self-reported Daily Opioid Users
Authors' conclusion
A single Narcan dose reversed moderate fentanyl- and sufentanil-induced respiratory depression, although effectiveness varied by endpoint and opioid receptor affinity.
Study context
- Population
- Opioid-naive individuals and self-reported daily opioid users with fentanyl- or sufentanil-induced moderate respiratory depression (30 to 40% reduction in minute ventilation)
- Participants
- 12 vs 18
- Exposure
- Opioid-naive vs Daily opioid users
- Opioid-naiven = 12
- Daily opioid usersn = 18
- Outcome
- Time to reversal of diminished minute ventilation and elevated end-tidal pCO2
Methodological detailsContinuous opioid infusions, which do not occur in real-world overdose settings (limitation)
- Continuous opioid infusions, which do not occur in real-world overdose settings (limitation)
Main finding
As reported in the abstract
- Minute ventilation restored by Narcan across all participants
- 2 to 4 min
- Delayed reversal of end-tidal pCO2
- 11 to 17 min
- pCO2 recovery during sufentanil exposure, opioid-naive
- 8
- pCO2 recovery during sufentanil exposure, daily opioid users
- 10
- Blood-effect-site equilibration half-life, minute ventilation reversal
- 0 to 1 min
- Blood-effect-site equilibration half-life, end-tidal pCO2
- 2 to 11 min
Observational data: associations, not effects.
Safety
- Withdrawal symptoms — Daily opioid users
- 7 events
- Withdrawal symptoms: 7 of 18 daily opioid users participated once in the study because of withdrawal symptoms
Original publication
Intranasal Naloxone Reversal of Opioid-induced Respiratory Depression in Opioid-naive Individuals and Self-reported Daily Opioid Users. Anesthesiology. Published 5 February 2026. doi:10.
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