Opioid Delivery Modality • Multimod

Opioid Delivery Modality • Multimodal pain management strategies are opioid dose sparing
• Risk is similar among the systemic (oral, intravenous [IV], subcutaneous, intramuscular)
routes of opioid administration
• Risk is similar for IV PCA and nurse-administered PRN IV opioids.
• Single epidural opioid bolus administration of extended-release morphine carries a higher
risk than IV PCA
• Recognize that delivery modalities (smart pumps) that interrupt opioid administration at set
pulse oximetry or capnography thresholds may result in loss of pain control and the need
to administer even more opioid to reestablish control.
• Double-check PCA medication at initiation and change of drug reservoir; utilize bar-code
identification systems.