An opioid agent is usually used in combination with an anaesthetic agent and a muscle relaxant. Morphine and papaveretum are less favoured because of their tendency to produce sustained post-operative respiratory depression.
A small dose of opioid such as fentanyl or alfentanyl just before the intravenous induction agent is a means of reducing the dose of the latter needed for induction. This is useful in patients with more attendant risks.
Care must be taken not to administer too frequent analgesia intraoperatively. Respiratory depression may occur, there is a reduction in the post-operative analgesic requirements, and occasionally, reversal with naloxone is necessitated.
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