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Perioperative uses of intravenous opioids in adults

Elizabeth Casserly, PharmD, BCPS
John C Alexander, MD
Section Editor
Girish P Joshi, MB, BS, MD, FFARCSI
Deputy Editor
Nancy A Nussmeier, MD, FAHA


Intravenous (IV) opioids are commonly used to provide analgesia and supplement sedation during general anesthesia or monitored anesthesia care (MAC), and are the most widely used agents for treatment of acute pain in the immediate postoperative period.

Opioids selected for perioperative use bind primarily to mu receptors in the central nervous system to produce excellent analgesia, as well as respiratory depression, miosis, and euphoria. Opioid binding to mu receptors in the peripheral nervous system produces additional effects such as cough suppression (bronchial receptors) and opioid-induced constipation (intestinal receptors). (See "Opioid use disorder: Epidemiology, pharmacology, clinical manifestations, course, screening, assessment, and diagnosis", section on 'Mechanism of action'.)

This topic will review perioperative uses, benefits, and adverse effects of IV opioid agents. Topics that review use of opioids in other settings (eg, critical care, palliative care, chronic pain management) are available elsewhere:

(See "Pain control in the critically ill adult patient", section on 'Opioid analgesics'.)

(See "Pain assessment and management in the last weeks of life".)

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Literature review current through: Oct 2017. | This topic last updated: Nov 02, 2017.
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