- The risk of postoperative opioid-induced respiratory depression (OIRD) is significantly higher in surgical patients with coexisting cardiac disease, pulmonary disease, or obstructive sleep apnea (OSA).
- 80% of postoperative OIRD cases occurred within 12 hours after surgery.
Why this matters
- OIRD is the major cause of opioid-related death and is the most serious complication from postoperative pain management with opioids.
- This is the first meta-analysis to identify risk factors associated with OIRD in surgical patients.
- This systematic review and meta-analysis identified 12 observational studies that evaluated adult patients (aged, ≥18 years) who were administered opioids after surgery.
- Funding: None disclosed.
- 4194 patients (0.5%) out of 841,424 surgical patients developed postoperative OIRD (incidence, 5.0 cases/1000 anesthetics delivered; 95% CI, 4.83-5.14).
- Among postoperative OIRD events, 80% occurred within first 12 hours and 85% within first 24 hours.
- Risk for postoperative OIRD was higher in patients with coexisting:
- cardiac disease (OR, 1.79; P<.002 i>2, 0%),
- pulmonary disease (OR, 2.27; P<.001 i>2, 0%), and
- OSA (OR, 1.4; P=.0003; I2, 31%).
- Mild cases of OIRD may not be reported, leading to measurement bias.
- Heterogeneity among included studies.
Coauthored with Antara Ghosh, PhD