The immunomodulatory effects of opioids and implications for intensive care unit populations

Pharmacotherapy. 2021 Aug;41(8):668-675. doi: 10.1002/phar.2602. Epub 2021 Jul 1.

Abstract

Analgesia within the intensive care unit (ICU) is often achieved via the utilization of opioids in alignment with current guidelines. Recent evidence has not only demonstrated the potential impact of opioids in suppression of immune function, but also the potential harm of immunosuppression of patients within the ICU. Despite the potential immunosuppression seen with opioids in this at-risk population, their use remains frequent. In this review, we highlight the potential immunomodulatory impact of opioids within the critically ill and considerations for their use.

Keywords: analgesia; immunology; infectious disease; septic shock.

Publication types

  • Review

MeSH terms

  • Analgesics, Opioid* / immunology
  • Analgesics, Opioid* / therapeutic use
  • Critical Illness
  • Humans
  • Immunomodulating Agents* / therapeutic use
  • Intensive Care Units

Substances

  • Analgesics, Opioid
  • Immunomodulating Agents