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01-03-2025 | Pharmacokinetics | Systematic Review

Pharmacokinetics of Opioid Infusions in the Adult Intensive Care Unit Setting—A Systematic Review

Authors: Johannie Beaucage-Charron, Justine Rinfret, Guillaume Trottier, Marie-Maxim Sévigny, Lisa Burry, Amélie Marsot, David Williamson

Published in: Clinical Pharmacokinetics

Abstract

Introduction

Pharmacokinetics (PKs) of drugs are often altered in the intensive care unit (ICU). Opioids are often used in the ICU, particularly as continuous infusions, and their characteristics lead them to undergo PK alterations. We conducted a systematic review to assess the PK of opioid infusions in the ICU.

Methods

Embase, MEDLINE, PubMed, CINAHL, and Evidence-Based Medicine Reviews (EBMR) were searched from inception to March 2024. Studies were included if they evaluated PKs of opioid infusions in adult patients in the ICU. Two reviewers independently selected and extracted data.

Results

Out of the 1040 records screened, 17 studies were included. Five studies were conducted on fentanyl, seven on morphine, one on hydromorphone, two on remifentanil, two on alfentanil, and one on sufentanil. Most studies where observational studies or case series. The mean age was 56 years old. Duration of the infusion varied between 3 h and 20 days. PKs of fentanyl, sufentanil, and hydromorphone were significantly impaired, whereas the PKs of morphine, alfentanil, and remifentanil were impaired to a lesser degree. The PK parameter that was most affected by critical illness was the half-life (T½).

Conclusions

To counter these PK alterations, new therapeutic avenues must be further explored in the ICU to individualize opioid infusions.

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Title: Pharmacokinetics of Opioid Infusions in the Adult Intensive Care Unit Setting—A Systematic Review
Authors: Johannie Beaucage-Charron
Justine Rinfret
Guillaume Trottier
Marie-Maxim Sévigny
Lisa Burry
Amélie Marsot
David Williamson
Publication date: 01-03-2025
Publisher: Springer International Publishing
Keywords: Pharmacokinetics
Opioids
Opioids
Fentanyl
Alfentanil
Morphine
Remifentanil
Sufentanil
Hydromorphone
Published in: Clinical Pharmacokinetics
Print ISSN: 0312-5963
Electronic ISSN: 1179-1926
DOI: https://doi.org/10.1007/s40262-025-01490-8

Podcast | Sexual health in older age

Springer Medicine

Pharmacokinetics of Opioid Infusions in the Adult Intensive Care Unit Setting—A Systematic Review

Abstract

Introduction

Methods

Results

Conclusions

Podcast | Sexual health in older age

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusions

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