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Table

Table 5-2 First-line IV Opioids Administered for Postoperative Pain Management: Pharmacokinetic Information

Opioid

Onset (min)

Peak (min)

Duration (hrs)

Half-life (hrs)

Morphine

0-10

15-30

3-4

2-4

Hydromorphone

5

15-30

3-4

2-3

Fentanyl

3-5

15-30

2

3-4

Data from Pasero, C., Quinn, T. E., Portenoy, R. K., McCaffery, M., & Rizos, A. (2011). Opioid analgesics. In C. Pasero & M. McCaffery (Eds.), Pain assessment and pharmacologic management (pp. 277-622). St. Louis, MO: Mosby.

Of all of the routes of administration, IV produces the highest peak concentration of the drug, and the peak concentration is associated with the highest level of toxicity (e.g., sedation). To decrease the peak effect and lower the level of toxicity, IV boluses may be administered more slowly or smaller doses may be administered more often.

Duration of analgesia is dose dependent; the higher the dose, usually the longer the duration.