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Unwanted effects

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

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

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