Evidence map›Paper›PMID 30552274›Full record

SynthesisBMJ open2018

Risk factors for opioid-induced respiratory depression in surgical patients: a systematic review and meta-analyses.

Kapil Gupta, Mahesh Nagappa, Arun Prasad, Lusine Abrahamyan, Jean Wong, Toby N Weingarten, Frances Chung

2 registry-linked trialsOpen access · goldAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMJ open, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 67 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
67citing papers in PubMed, 2 pooled it
13.6field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04944225 naunknown statusnot on this mapstarted 2024, after this paper: background citation

Implementation of a Multi-faceted Opioid-Use Reduction Strategy for South Western Ontario: A Pragmatic Stepped-Wedge Cluster Randomized Trial

TypeinterventionalSponsorLondon Health Sciences Centre Research Institute OR Lawson Research Institute of St. Joseph'sRan2024 to 2025Enrolled100,000ConditionsOpioid UseArmsOpioid Reduction Strategy
NCT07753785 not yet recruitingnot on this mapstarted 2026, after this paper: background citation

Effects of Oliceridine Versus Sufentanil Analgesia on Incidence of Postoperative Respiratory Depression in Patients at High-Risk of Obstructive Sleep Apnea: A Prospective Cohort Study

TypeobservationalSponsorPeking University First HospitalRan2026 to 2029Enrolled851ConditionsObstructive Sleep Apnea, Postoperative Analgesia, Oliceridine, SufentanilArmsOliceridine, Sufentanil
3 · Its place in the literature

Who cites it

67 citing papers in PubMed, 2 syntheses or guidelines pooled it, 171 citations in OpenAlex.

  1. Pooled it
  2. Prevalence of sleep-disordered breathing in opioid users with chronic pain: a systematic review and meta-analysis.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2020
    Pooled it
  3. Trial
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  17. Opioids and Respiratory Related Consequences.Sleep medicine clinics · 2025
    Review
  18. Review
  19. Mitragynine and 7-hydroxymitragynine: Bidirectional effects on breathing in rats.The Journal of pharmacology and experimental therapeutics · 2025
    Article
  20. Review

7 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 4 institutions in 2 countries.

Kapil GuptaDepartment of Anesthesia and Pain Management, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada.
Mahesh NagappaDepartment of Anesthesia and Perioperative Medicine, London Health Sciences Centre and St. Joseph Health Care, Western University, London, Ontario, Canada.
Arun PrasadDepartment of Anesthesia and Pain Management, University Health Network, University of Toronto, Toronto, Ontario, Canada.
Lusine AbrahamyanInstitute of Health Policy, Management and Evaluation, University of Toronto THETA Collaborative, Toronto General Research Institute, Toronto, Ontario, Canada.
Jean WongDepartment of Anesthesia and Pain Management, University Health Network, University of Toronto, Toronto, Ontario, Canada.ORCID 0000-0002-7213-4898
Toby N WeingartenDepartment of Anesthesia and Perioperative Medicine, Mayo Clinic Rochester, Rochester, Minnesota, USA.
Frances ChungDepartment of Anesthesia and Pain Management, University Health Network, University of Toronto, Toronto, Ontario, Canada.
University Health Network · CAMayo Clinic · USUniversity of Toronto · CAWestern University · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveThis systematic review and meta-analysis aim to evaluate the risk factors associated with postoperative opioid-induced respiratory depression (OIRD).

designSystematic review and meta-analysis. DATA SOURCES: PubMed-MEDLINE, MEDLINE in-process, EMBASE, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, PubMed and Clinicaltrials.gov (January 1946 to November 2017). ELIGIBILITY CRITERIA: The inclusion criteria were: (1) adult patients 18 years or older who were administered opioids after surgery and developed postoperative OIRD (OIRD group); (2) all studies which reported both OIRD events and associated risk factors; (3) all studies with reported data for each risk factor on patients with no OIRD (control group) and (4) published articles in English language. DATA ANALYSIS: We used a random effects inverse variance analysis to evaluate the existing evidence of risk factors associated with OIRD. Newcastle-Ottawa scale scoring system was used to assess quality of study.

resultsTwelve observational studies were included from 8690 citations. The incidence of postoperative OIRD was 5.0 cases per 1000 anaesthetics administered (95% CI: 4.8 to 5.1; total patients: 841 424; OIRD: 4194). Eighty-five per cent of OIRD occurred within the first 24 hours postoperatively. Increased risk for OIRD was associated with pre-existing cardiac disease (OIRD vs control: 42.8% vs 29.6%; OR: 1.7; 95% CI: 1.2 to 2.5; I

conclusionPatients with cardiac, respiratory disease and/or obstructive sleep apnoea were at increased risk for OIRD. Patients with postoperative OIRD received higher doses of morphine equivalent daily dose.

Indexed as

Analgesics, OpioidHeart DiseasesHumansLength of StayPostoperative PainRespiration DisordersRespiratory InsufficiencyRisk FactorsSleep Apnea, ObstructiveAnalgesics, Opioidanaesthesiaopioidspostoperative complicationsrespiratory depressionrisk factorssurgery

Identifiers

PMID30552274
PMCPMC6303633
OpenAlexW2903733020

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.