ReviewArchives of toxicology2022
Mechanisms of opioid-induced respiratory depression.
Review in Archives of toxicology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06225466 (Anesthesia With Neuromuscular Blockade and Reversal With Sugammadex Compared to Anesthesia Without Muscle Relaxation During Pediatric High-Risk Adenotonsillectomy), which is not on this map. Cited by 56 papers, 2 of them syntheses that pooled 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.
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.
Anesthesia With Neuromuscular Blockade and Reversal With Sugammadex Compared to Anesthesia Without Muscle Relaxation During Pediatric High-Risk Adenotonsillectomy: A Randomized-Controlled Trial
Who cites it
56 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Oxygen Saturation Thresholds for Opioid-induced Respiratory Depression: A Systematic Review.The western journal of emergency medicine · 2026Pooled it
- Effects of different exercise types on craving in substance use disorder patients with drug dependence -network meta-analysis and dose-response relationships based on frequentist and Bayesian models.Addiction science & clinical practice · 2025Pooled it
- Respiratory Depression Following Concomitant Infusion of Remimazolam and Remifentanil Using Targeted Effect-Site Concentrations: A Randomized Controlled Trial.Medicina (Kaunas, Lithuania) · 2026Trial
- A comparison of the effects of oliceridine and sufentanil on the quality of recovery after hysteroscopic surgery: a prospective double-blind randomized controlled trial.Journal of anesthesia · 2026Trial
- Photoplethysmography parameters in monitoring nociception during general anesthesia.BMC anesthesiology · 2025Trial
- Synthetic opioid contamination in Brazil's illicit drug market: an emerging and underdetected risk.Lancet regional health. Americas · 2026Article
- Safety signals for drug-related respiratory depression: a disproportionality analysis of the FDA Adverse Event Reporting System (FAERS).Journal of thoracic disease · 2026Article
- Review
- Carfentanil Depresses Inspiratory Motor Drive.Journal of substance abuse and alcoholism · 2026Article
- Opioid use disorder and dementia risk: evidence from observational and genetic analyses in diverse ancestry cohorts.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2026Article
- Outcompeting opioid-induced respiratory depression.Journal of thoracic disease · 2026Article
- Potentiation of fentanyl-induced respiratory depression by alcohol is not fully reversed by naloxone.JCI insight · 2026Article
- Indole Alkaloids as Biased Opioid Receptor Modulators.Pharmaceuticals (Basel, Switzerland) · 2026Review
- A comprehensive review on pain: Model, target, therapy, and prospect (Review).International journal of molecular medicine · 2026Review
- Article
- Effects of Intravenous Bolus Injection of Fentanyl on Phrenic Nerve Activity and Its Response to Hypoxia and Hypercapnia.Journal of pharmacy and pharmacology research · 2026Article
- The Role of Danavorexton for Perioperative Opioid-Induced Respiratory Depression and Sedation: A Narrative Review.Clinical pharmacology : advances and applications · 2026Review
- Relationship between morphine rescue dose and respiratory safety during breakthrough cancer pain in lung cancer patients treated with high-dose opioids.American journal of cancer research · 2026Article
- Overdose-Related Cardiac Arrest in the Era of the Opioid Epidemic.Critical care clinics · 2026Review
- A Comprehensive Evidence-Based Review of Non-Pharmaceutical Interventions for Neonatal Pain.Journal of pain research · 2026Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Opioid-induced respiratory depression (OIRD), the primary cause of opioid-induced death, is the neural depression of respiratory drive which, together with a decreased level of consciousness and obstructive sleep apnea, cause ventilatory insufficiency. Variability of responses to opioids and individual differences in physiological and neurological states (e.g., anesthesia, sleep-disordered breathing, concurrent drug administration) add to the risk. Multiple sites can independently exert a depressive effect on breathing, making it unclear which sites are necessary for the induction of OIRD. The generator of inspiratory rhythm is the preBötzinger complex (preBötC) in the ventrolateral medulla. Other important brainstem respiratory centres include the pontine Kölliker-Fuse and adjacent parabrachial nuclei (KF/PBN) in the dorsal lateral pons, and the dorsal respiratory group in the medulla. Deletion of μ opioid receptors from neurons showed that the preBötC and KF/PBN contribute to OIRD with the KF as a respiratory modulator and the preBötC as inspiratory rhythm generator. Glutamatergic neurons expressing NK-1R and somatostatin involved in the autonomic function of breathing, and modulatory signal pathways involving GIRK and KCNQ potassium channels, remain poorly understood. Reversal of OIRD has relied heavily on naloxone which also reverses analgesia but mismatches between the half-lives of naloxone and opioids can make it difficult to clinically safely avoid OIRD. Maternal opioid use, which is rising, increases apneas and destabilizes neonatal breathing but opioid effects on maternal and neonatal respiratory circuits in neonatal abstinence syndrome (NAS) are not well understood. Methadone, administered to alleviate symptoms of NAS in humans, desensitizes rats to RD.
Indexed as
Identifiers
35471232What OpenQuestion holds
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.