Management of opioid related side effects: Patients with satisfactory analgesia but experiencing unwanted sedation will be assessed by a study physician. Patients experiencing hypotension, will be given a 500mL crystalloid bolus and will assessed by a study physician. Patients with significant respiratory depression will be given naloxone in 40μg boluses until respiratory rate is >10 and will be sedation will assessed by a study physician. Patients experiencing pruritis, nausea, or insomnia will be managed with the medications outlined in the Study Checklist (Appendix 2) and these orders will be on the APS order sheet that will have been completed with the Study Checklist at the time of enrollment.