Opiates and the development of post-injury complications: a review

Opiates are the analgesic of choice for the treatment of post-burn, -trauma and -surgical pain, however, it is also well-established that opiates can induce immune complications. These complications, independent of the analgesic regime, are also associated with severe traumatic injuries, such as burns. Recent findings suggest that opiates can contribute to immune and infectious complications in experimental and clinical settings. Based on the immunomodulatory properties of opiate analgesics their therapeutic use/misuse post-injury may contribute to the development of complications leading to increased morbidity and mortality in this patient population. An improved understanding of the relationship(s) between opiates and complications following major injury, such as burn trauma is likely to contribute towards an improvement in existing, as well as the development of new therapeutic regimes. This review will focus on the role of opiate analgesic usage and abuse and in the development of complications following major traumatic injury with a particular emphasis on burn injury.