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The most commonly used term, respiratory depression, only describes part of that risk. Opioid-induced ventilatory impairment (OIVI) is a more complete term encompassing opioid-induced central respiratory depression (decreased respiratory drive), decreased level of consciousness (sedation) and upper airway obstruction, all of which, alone or in combination, may result in decreased alveolar ventilation and increased arterial carbon dioxide levels.<\/jats:p>\n                  <jats:p>Concerns about OIVI are warranted, as deaths related to opioid administration in the acute pain setting continue to be reported. Risks are often said to be higher in patients with obstructive sleep apnoea. However, the tendency to use the term \u2018obstructive sleep apnoea\u2019 to encompass the much broader spectrum of sleep- and obesity-related hypoventilation syndromes and the related misuse of terminology in papers relating to obstructive sleep apnoea and sleep-disordered breathing remain significant problems in discussions of opioid-related effects.<\/jats:p>\n                  <jats:p>Opioids given for management of acute pain must be titrated to effect for each patient. However, strategies aiming for better pain scores alone, without highlighting the need for appropriate monitoring of OIVI, can and will lead to an increase in adverse events. Therefore, all patients must be monitored appropriately for OIVI (at the very least using sedation scores as a \u20186th vital sign\u2019) so that it can be detected at an early stage and appropriate interventions triggered.<\/jats:p>","DOI":"10.1177\/0310057x1103900405","type":"journal-article","created":{"date-parts":[[2019,1,22]],"date-time":"2019-01-22T23:39:02Z","timestamp":1548200342000},"page":"545-558","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":144,"title":["Opioids, Ventilation and Acute Pain Management"],"prefix":"10.1177","volume":"39","author":[{"given":"P. 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