Low-dose naltrexone in the perioperative period

Low-dose naltrexone (LDN) therapy for chronic pain conditions is growing in popularity in the USA. This off-label use of LDN may be partially attributed to patients searching for safe and well-tolerated treatments to improve symptoms and quality of life or as an alternative to chronic opioid therapy.1 2 With its increase in use, anaesthesiologists are likely to encounter patients on LDN therapy, but guidelines for managing LDN during the perioperative period have not been established, and it is unclear if LDN therapy should be continued, dose reduced, or stopped prior to surgery.