A cursory glance through the Wikipedia article didn’t address this, so I’ll ask it here: What happens if someone on Naltrexone gets into a severe accident and needs immediate effective pain control? What if he needs an emergency operation? Don’t all really effective anaesthetics/analgesics bind to opiod receptors?
But basically under controlled conditions, naltrexone can be over-ridden by a good anesthesiologist. As long as the anesthesiologist knows that naltrexone is on board.