{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T09:08:58Z","timestamp":1789722538862,"version":"4.0.1"},"reference-count":29,"publisher":"Wiley","issue":"9pt2","license":[{"start":{"date-parts":[[2012,9,6]],"date-time":"2012-09-06T00:00:00Z","timestamp":1346889600000},"content-version":"vor","delay-in-days":5,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["accpjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacotherapy"],"published-print":{"date-parts":[[2012,9]]},"abstract":"\n \n \n Opioid\u2010related adverse drug events (\n ORADE<\/jats:styled-content>\n s) can have a significant impact on patient recovery after surgery. This review investigates the impact of two\n ORADE<\/jats:styled-content>\n s, respiratory depression and postoperative ileus (\n POI<\/jats:styled-content>\n ), on clinical and economic outcomes. Opioid\u2010induced ventilatory impairment is a potentially serious\n ORADE<\/jats:styled-content>\n that can result in apnea and even death. The incidence of ventilatory impairment is approximately 1%, even among patients receiving opioids using patient\u2010controlled analgesia. Costs are increased in patients treated with opioids who are at high risk of ventilatory impairment due to the need for more intensive monitoring from nursing staff and the use of alarmed monitoring equipment. Opioids, together with other factors, contribute to the development of\n POI<\/jats:styled-content>\n through a direct effect on gut motility.\n Postoperative ileus<\/jats:styled-content>\n has been shown to significantly increase hospital length of stay and cost of care. A key determinant of ileus development, as well as\n length of stay<\/jats:styled-content>\n and costs, is postsurgical opioid dose. Data from a retrospective analysis show that a daily hydromorphone dose of 2\u00a0mg\/day markedly increases the risk of\n POI<\/jats:styled-content>\n . In addition, although the incidence of\n POI<\/jats:styled-content>\n is reduced in patients who undergo laparoscopic surgery or hand\u2010assisted laparoscopic surgery compared with open surgery, the reduction of\n POI<\/jats:styled-content>\n can potentially be negated by excessive opioid use. Therefore, multimodal, opioid\u2010sparing strategies should be explored and used to reduce severe\n ORADE<\/jats:styled-content>\n s and improve outcomes in the surgical setting.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/j.1875-9114.2012.01178.x","type":"journal-article","created":{"date-parts":[[2012,9,6]],"date-time":"2012-09-06T17:05:55Z","timestamp":1346951155000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":55,"title":["Clinical and Economic Burden of Opioid Use for Postsurgical Pain: Focus on Ventilatory Impairment and Ileus"],"prefix":"10.1002","volume":"32","author":[{"given":"Jeffrey F.","family":"Barletta","sequence":"first","affiliation":[{"name":"Department of Pharmacy Practice College of Pharmacy\u2013Glendale Midwestern University Glendale 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