unwanted effects

Last reviewed 01/2018

The key adverse effect of opioids in infants is respiratory depression. This may be guarded against by the following measures:

  • regular monitoring of the patient:
    • rate of respiration
    • depth of respiration
    • level of sedation
  • sufficient staffing for immediate resuscitation

Should respiratory depression occur, the following measures should be commenced:

  • secure airway
  • adequate oxygenation and ventilation
  • stop or slow opioid infusion
  • naloxone may be given every 3-5 minutes by slow IV injection at a rate of 2 æg/kg up to a maximum of 10 æg/kg. Its action is short-lived and so continued observation is essential.

Other adverse effects of opioids in infants include:

  • gastric stasis
  • vomiting
  • constipation
  • urinary retention
  • increased intraluminal pressure in the gut - causes breakdown of anastomoses
  • dependence after a period of several days / weeks - gradual weaning is required