Opioid analgesia is indicated for the treatment of moderate to severe pain. An opioid is a medication that relieves pain by binding to opioid receptors in the central nervous system spinal cord and peripheral nervous system. This guideline does not cover opioid delivery via patient controlled analgesia (PCA) delivery. Show
AimTo provide medical and nursing staff at the Royal Children’s Hospital with a clear outline for assessment and management of a patient receiving opioids as an inpatient, including administration and adverse events associated with administration. Definition of Terms
PharmacologyThere are three main types of opioid receptors, these receptors have multiple actions:
Delta (d) receptors are involved with modulation of mu receptors. Primarily responsible for spinal analgesia Opioids are metabolised in the liver and excreted via the kidneys. Morphine is the most commonly used opioid of choice, and has two main metabolites M3G and M6G. M3G (morphine -3 glucuronide) has no analgesic action, but can cause neurotoxic effects such as tremor and myoclonus. M6G (morphine – 6 – glucuronide) is a powerful analgesic. Table 1: Side effects of opioids Neurological
Cardiovascular
Gastrointestinal/Renal
Musculoskeletal
Table 2: List of opioid medications
|