American Society for Pain Management Nursing guidelines on monitoring for opioid-induced sedation and respiratory depression.

As the complexity of analgesic therapies increases, priorities of care must be established to balance aggressive pain management with measures to prevent or minimize adverse events and to ensure high quality and safe care. Opioid analgesia remains the primary pharmacologic intervention for managing pain in hospitalized patients. Unintended advancing sedation and respiratory depression are two of the most serious opioid-related adverse events.

Comparison of opioid requirements and analgesic response in opioid-tolerant versus opioid-naïve patients after total knee arthroplasty.

Study Objectives: To compare opioid requirements in opioid-tolerant and opioid-naïve patients after total knee arthroplasty, and to compare pain scores, sedation scores, and adverse effects between the groups.

Design: Prospective, observational study.

Setting: Academic medical center.

Opioid tolerance: a perioperative nursing challenge.

Opioid analgesia is used more frequently in patients with chronic pain unresponsive to non-opioid therapy. The result is a growing number of individuals admitted to the hospital for acute pain (trauma or surgery) who are opioid-tolerant. Nursing strategies to improve pain intervention in this population are discussed.