2018: Opioid induced ventilatory impairment



·         Summary

·         Manufacturer’s recommendations

·         College recommendations



·         There is significant variation in opioid PK and PD

·         (Infusion + PCA) and (SR + IR) are functionally identical combinations

·         -Both combinations have been lethal when used for acute pain


Manufacturer’s recommendations:

·         Fentanyl patches are not approved for opioid-naïve patients

·         Slow-release opioids are not approved for acute pain


College recommendation:

·         If opioid-naïve: don’t start SR opioid until 24 hours after surgery

·         If already on SR opioid: continue peri-operatively


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