Indications

• xxx

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Pharmacology

• Opiate (see Opiates, [[Opiates]])

Pharmacokinetics

• Onset: 5 min
• Half-Life: 90-111 min
• Duration of Action: 30-60 min

Metabolism

• Hepatic

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Administration

• IV

Dose Adjustment

• Hepatic:
• Renal:

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Adverse Effects

Neurologic Adverse Effects

Tonic Muscle Rigidity [MEDLINE]

• Epidemiology: may also been seen with fentanyl, sufentanil, and morphine
• Clinical: may involve chest and abdominal wall
  • Decreased Compliance/Increased Peak Inspiratory Pressures (PIP) on Mechanical Ventilation (see Ventilator Troubleshooting, [[Ventilator Troubleshooting]])
• Treatment
  • Naloxone (Narcan) (see Naloxone, [[Naloxone]]): may be used in cases where reversal of the effect of the opiate would not be detrimental
  • Pharmacologic Paralysis: may be required in cases where reversal of the effect of the opiate would be deterimental

Other Adverse Effects

• xxx
• xxx
• xxx

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References

• Postoperative myoclonus and rigidity after anesthesia with opioids.  Anesth Analg 1994; 78:783-786 [MEDLINE]