Impact of Age, Sex and Route of Administration on Adverse Events After Opioid Treatment in the Emergency Department: a Retrospective Study

Overview

Journal Pain Res Manag

Date 2015 Feb 10

PMID 25664538

Citations 18

Authors

Raoul Daoust

Jean Paquet

Gilles Lavigne

Eric Piette

Jean-Marc Chauny

Affiliations

Soon will be listed here.

Abstract

Background: The efficacy of opioids for acute pain relief in the emergency department (ED) is well recognized, but treatment with opioids is associated with adverse events ranging from minor discomforts to life-threatening events.

Objective: To assess the impact of age, sex and route of administration on the incidence of adverse events due to opioid administration in the ED.

Methods: Real-time archived data were analyzed retrospectively in a tertiary care urban hospital. All consecutive patients (≥16 years of age) who were assigned to an ED bed and received an opioid between March 2008 and December 2012 were included. Adverse events were defined as: nausea⁄vomiting (minor); systolic blood pressure (SBP) <90 mmHg, oxygen saturation (Sat) <92% and respiration rate <10 breaths⁄min (major) within 2 h of the first opioid doses.

Results: In the study period, 31,742 patients were treated with opioids. The mean (± SD) age was 55.8±20.5 years, and 53% were female. The overall incidence of adverse events was 12.0% (95% CI 11.6% to 12.4%): 5.9% (95% CI 5.6% to 6.2%) experienced nausea⁄vomiting, 2.4% (95% CI 2.2% to 2.6%) SBP <90 mmHg, 4.7% (95% CI 4.5% to 4.9%) Sat that dropped to <92% and 0.09% respiration rate <10 breaths⁄min. After controlling for confounding factors, these adverse events were associated with: female sex (more nausea⁄vomiting, more SBP <90 mmHg, less Sat <92%); age ≥65 years (less nausea⁄vomiting, more SBP <90 mmHg, more Sat <92%); and route of administration (intravenous > subcutaneous > oral).

Conclusions: The incidence of adverse events associated with opioid administration in the ED is generally low and is associated with age, sex and route of administration.

Citing Articles

Misuse, Abuse and Medication Errors' Adverse Events Associated with Opioids-A Systematic Review.

Gustafsson M, Silva V, Valeiro C, Joaquim J, van Hunsel F, Matos C Pharmaceuticals (Basel). 2024; 17(8).

PMID: 39204114 PMC: 11357286. DOI: 10.3390/ph17081009.

Opioid prescribing requirements to minimize unused medications after an emergency department visit for acute pain: a prospective cohort study.

Daoust R, Paquet J, Emond M, Iseppon M, Williamson D, Yan J CMAJ. 2024; 196(25):E866-E874.

PMID: 39009368 PMC: 11268147. DOI: 10.1503/cmaj.231640.

Editorial: Optimizing opioid prescriptions in the emergency department.

Dahaba A, Nannan Panday R BMC Emerg Med. 2023; 23(1):106.

PMID: 37726650 PMC: 10510214. DOI: 10.1186/s12873-023-00880-0.

Gender Differences in Medication Adverse Effects Experienced by People Living With Chronic Pain.

Nguena Nguefack H, Page M, Guenette L, Blais L, Diallo M, Godbout-Parent M Front Pain Res (Lausanne). 2022; 3:830153.

PMID: 35620635 PMC: 9128021. DOI: 10.3389/fpain.2022.830153.

Comparison of the Efficacy of Nonsteroidal Anti-Inflammatory Drugs and Opioids in the Treatment of Acute Renal Colic: A Systematic Review and Meta-Analysis.

Leng X, Liu C, Wang S, Peng H, Wang D, Pan H Front Pharmacol. 2022; 12:728908.

PMID: 35153734 PMC: 8828916. DOI: 10.3389/fphar.2021.728908.

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