A review of the incidence, causes, consequences, and management of gastrointestinal effects associated with postoperative opioid administration.

Opioid analgesics are commonly used to manage moderate to severe postoperative pain. Classic mu-opioid receptor agonists, such as morphine, meperidine, and fentanyl, provide excellent analgesia. However, their use in the postoperative setting is often limited by adverse effects such as nausea, vomiting, and reduced gastrointestinal motility. Clinicians who care for postoperative patients need to be aware of the incidences, causes, risk factors, consequences, and management of these adverse effects. If these effects are not managed effectively, opioid-related complications may significantly increase patient morbidity, have a negative impact on patient outcomes, and increase the burden on the nursing staff. Strategies are available to minimize and treat opioid-related adverse effects. Implementation of these strategies should result not only in increased patient comfort and satisfaction, but also in decreases in lengths of stay, more effective nursing care, and decreases in associated hospital costs.