title: Side effects of opioids during short-term administration: effect of age, gender, and race.
abstract: OBJECTIVE
  Little is known about risk factors that increase the risk of development of opioid side effects. Our objective was to evaluate the effect of the type of opioid, age, gender, and race on the incidence of side effects from short-term opioid use.
  
  
  METHODS
  A secondary analysis of a retrospective cohort study in 35 community-based and tertiary hospitals was done. There were 8855 black or white subjects aged 16 years and older. Patients received meperidine (INN, pethidine), morphine, or fentanyl as part of their treatment. Measurements were made to assess the presence of nausea and vomiting and respiratory depression.
  
  
  RESULTS
  Of the patients, 26% had nausea and vomiting and 1.5% had respiratory depression after opioid administration. After adjustment for opioid dose, route of administration, age, gender, and race, meperidine produced less nausea and vomiting (odds ratio [OR] = 0.7; 95% confidence interval [CI], 0.5-0.8) and less respiratory depression (OR = 0.6; 95% CI, 0.2-0.9) than morphine. The risk of respiratory depression increased with age. Compared with patients aged between 16 and 45 years, those aged between 61 and 70 years had 2.8 times the risk of development of respiratory depression (95% CI, 1.2-6.6); those aged between 71 and 80 years had 5.4 times the risk (95% CI, 2.4-11.8); and those aged older than 80 years had 8.7 times the risk (95% CI, 3.8-20.0). Men had less nausea and vomiting than women (OR = 0.5; 95% CI, 0.4-0.6). White subjects had more nausea and vomiting than black subjects (OR = 1.4; 95% CI, 1.1-1.7).
  
  
  CONCLUSIONS
  Meperidine produced fewer side effects than morphine during short-term use. The risk of respiratory depression increases substantially after 60 years of age. Women have nausea and vomiting more often than men. The effect of race deserves further investigation.
authors.affiliation: Department of Anesthesiology, and Clinical Epidemiology Unit. Javeriana Univeristy, Bogota, Colombia.
authors.forename: M Soledad
authors.initials: MS
authors.lastname: Cepeda
authors.forename: John T
authors.initials: JT
authors.lastname: Farrar
authors.forename: Mona
authors.initials: M
authors.lastname: Baumgarten
authors.forename: Ray
authors.initials: R
authors.lastname: Boston
authors.forename: Daniel B
authors.initials: DB
authors.lastname: Carr
authors.forename: Brian L
authors.initials: BL
authors.lastname: Strom
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology*; D000701:Analgesics, Opioid / Q000009:adverse effects*; D015331:Cohort Studies; D005260:Female; D005283:Fentanyl / Q000009:adverse effects; D006801:Humans; D020911:Ketorolac Tromethamine / Q000009:adverse effects; D008297:Male; D008614:Meperidine / Q000009:adverse effects; D008875:Middle Aged; D009020:Morphine / Q000009:adverse effects; D009325:Nausea / Q000139:chemically induced / Q000453:epidemiology; D010414:Pennsylvania / Q000453:epidemiology; D011358:Product Surveillance, Postmarketing; D044469:Racial Groups; D012131:Respiratory Insufficiency / Q000139:chemically induced; D012189:Retrospective Studies; D012727:Sex Characteristics; D014839:Vomiting / Q000139:chemically induced / Q000453:epidemiology
chemical_list: D000701:Analgesics, Opioid; D020911:Ketorolac Tromethamine; D009020:Morphine; D008614:Meperidine; D005283:Fentanyl