Opioids, respiratory depression, and sleep-disordered breathing

Best Pract Res Clin Anaesthesiol. 2017 Dec;31(4):469-485. doi: 10.1016/j.bpa.2017.05.004. Epub 2017 May 22.

Abstract

The increasing use of opioids in the perioperative period has increased opioid-associated morbidity and mortality. There is a well-established connection between opioids, sleep-disordered breathing (SDB), and respiratory depression. The treatment of postoperative pain with opioids in patients with SDB may result in respiratory depression. In an unmonitored setting, it may lead to life-threatening respiratory events. More studies are required to evaluate the effective management and prevention of respiratory depression in patients with SDB. This review summarizes the current state of knowledge relating to the pathophysiology of respiratory depression by opioids and opioid-related respiratory depression and appraises the association between opioids and SDB.

Keywords: opioids; postoperative pain; respiratory depression; sleep-disordered breathing.

Publication types

  • Review

MeSH terms

  • Analgesics, Opioid / administration & dosage
  • Analgesics, Opioid / adverse effects*
  • Animals
  • Brain / drug effects
  • Brain / physiology
  • Humans
  • Nerve Net / drug effects
  • Nerve Net / physiology
  • Pain, Postoperative / diagnosis
  • Pain, Postoperative / physiopathology
  • Pain, Postoperative / prevention & control*
  • Respiratory Insufficiency / chemically induced*
  • Respiratory Insufficiency / diagnosis
  • Respiratory Insufficiency / physiopathology
  • Sleep Apnea Syndromes / chemically induced*
  • Sleep Apnea Syndromes / diagnosis
  • Sleep Apnea Syndromes / physiopathology

Substances

  • Analgesics, Opioid