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 Considered the first line analgesic by the SCCM guidelines for ICU patients.

 As a class, they have some sedative properties when given in high enough doses, but have no amnestic effects.

 Side effects are reasonably universal and include respiratory depression, hypotension, itching, nausea and vomiting, miosis, and decreased gastric motility.

 Choice of opioid and dosage must be tailored to the individual patient. For example, a 24‐year‐old patient in a trauma ICU who was actively taking suboxone at the time of admission may require an order of magnitude more opioid for the first 24 hours than a 72‐year‐old patient with renal failure.