Modified-release opioid tablets were introduced into surgical practice in the belief that they provided superior pain relief and reduced nursing workload, and they rapidly became embedded into many perioperative pathways. Although national and international guidelines for the management of postoperative pain now advise against the use of modified-release opioids, they continue to be prescribed in many centres. Recognition that modified-release opioids show lack of benefit and increased risk of harm compared with immediate-release opioids in the acute, postoperative setting has become clear. Their slow onset and offset make rapid and safe titration of these opioids impossible, including down-titration as the patient recovers; pain relief may be less effective; they have been associated with an increased incidence of opioid-related adverse drug events, increased length of hospital stay, and higher readmission rates; and they lead to higher rates of opioid-induced ventilatory impairment and persistent postoperative opioid use. Evidence indicates that modified-release opioids should not be used routinely in the postoperative period.

改良释放的阿片类药物片剂被引入外科手术实践中，相信它们可以提供卓越的镇痛效果并减少护理工作量，并且它们迅速被嵌入到许多围手术期途径中。尽管现在有关术后疼痛管理的国家和国际指南建议不要使用缓释阿片类药物，但许多中心仍在开这种药。与速释阿片类药物相比，缓释阿片类药物在急性术后情况下缺乏获益且危害风险增加的认识已经变得清晰。它们缓慢起效和抵消使得无法快速安全地滴定这些阿片类药物，包括在患者康复时减量；止痛效果可能较差；它们与阿片类药物相关不良药物事件发生率增加、住院时间延长和再入院率增加有关；它们导致阿片类药物引起的通气障碍和术后持续使用阿片类药物的发生率更高。有证据表明，不应在术后常规使用缓释阿片类药物。