Postoperative opioid administration characteristics associated with opioid-induced respiratory depression: Results from the PRODIGY trial

Opioid administration for pain in general care floor patients remains common, and can lead to adverse outcomes, including respiratory compromise. The PRODIGY trial found that among ward patients receiving parenteral opioids, 46% experienced ≥1 respiratory depression episode. The objective of this analysis was to evaluate the geographic differences of opioid administration and examine the association between opioid administration characteristics and the occurrence of respiratory depression. Prospective observational trial. 16 general care medical and surgical wards in Asia, Europe, and the United States. 1335 patients receiving parenteral opioids. Blinded, alarm-silenced continuous capnography and pulse oximetry monitoring. Opioid-induced respiratory depression, defined as respiratory rate ≤ 5 bpm, SpO2 ≤ 85%, or ETCO2 ≤ 15 or ≥ 60 mmHg for ≥3 min; apnea episode lasting >30 s; or any respiratory opioid-related adverse event. Across all patients, 58% received only long-acting opioids, 16% received only short-acting (