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Intramuscular opioids

Authoring team

The intramuscular injection of opioids has been a popular form of treating postoperative pain. However, the subjective patient benefit has been less than desired.

This is because:

  • the pharmacokinetics and pharmacological effects of opioids vary greatly among patients - the minimum effective plasma concentration shows an eight fold range in the same surgical population; this is problematical as the therapeutic index for opioids is small
  • fear of adverse effects and misunderstanding of the risk of dependency have resulted in intramuscular opioids being administered too infrequently

The situation has improved now that alternative routes of administration are more widely used.

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