Impact of age, sex and route of administration on adverse events after opioid treatment in the emergency department: A retrospective study

Opioids are an important avenue for the treatment of pain among individuals presenting to the emergency department. Unfortunately, opioid administration can lead to several complications including nausea/vomiting, oxygen desaturation and hypotension. The authors aimed to determine the incidence of such adverse events among 31,742 patients who were treated with opioids in the emergency department of a single large tertiary care hospital in Montreal, Quebec.
BACKGROUND: The efficacy of opioids for acute pain relief in the emergency department (ED) is well recognized, but treatment with opioids is associated with adverse events ranging from minor discomforts to life-threatening events. OBJECTIVE: To assess the impact of age, sex and route of administration on the incidence of adverse events due to opioid administration in the ED. METHODS: Real-time archived data were analyzed retrospectively in a tertiary care urban hospital. All consecutive patients (≥16 years of age) who were assigned to an ED bed and received an opioid between March 2008 and December 2012 were included. Adverse events were defined as: nausea/vomiting (minor); systolic blood pressure (SBP) subcutaneous > oral). CONCLUSIONS: The incidence of adverse events associated with opioid administration in the ED is generally low and is associated with age, sex and route of administration.