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Updated: Jan 7, 2026

Objective Nociceptive Assessment in Ventilated ICU Patients: A Feasibility Study Using Pupillometry and the Nociceptive Flexion Reflex
Published on: July 4, 2018
Opioid Prescribing in Opioid-Naïve and Opioid-Exposed Mechanically Ventilated Medically Critically Ill Patients
Sarah R Peppard1, William J Peppard2, Jayshil Patel3
1Concordia University Wisconsin, Mequon, WI, USA.
Objective:
Characterize opioid prescribing patterns in the ICU and post-hospital discharge in invasively mechanically ventilated (IMV) opioid-naïve and opioid-exposed patients.
Design:
Single-center, retrospective cohort study.
Setting:
Tertiary academic medical center.
Patients Participants:
Patients requiring IMV admitted to the MICU.
Interventions:
None.
Main Outcomes Measures:
Difference in opioid prescriptions at discharge from the hospital and opioid use during IMV between groups.
Results:
A total of 85 patients were included, 60 (70.6%) were opioid-naïve and 25 (29.4%) were opioid-exposed prior to admission. Five (8.3%) opioid-naïve and 16 (64.0%) opioid-exposed were prescribed opioids on discharge (P < 0.001). Median morphine milligram equivalents (MME) per day during IMV did not differ between groups.
Conclusions:
Although opioid discharge prescribing was relatively uncommon among medical ICU patients who were opioid-naïve prior to admission, areas to evaluate and optimize opioid prescribing during IMV and at discharge were identified.
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Opioid Analgesics: Morphine and Other Natural Cogeners
Analgesia and Pain Management
Opioid Receptors: Overview
Mechanical Ventilation I: Indication and Settings
Parenteral Anesthetics: Overview

