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Respiratory depression after administration of single-dose neuraxial morphine for post-cesarean delivery analgesia: a retrospective cohort study.

Publication ,  Journal Article
Palleschi, GT; Gerasimov, M; Blitz, MJ; Aronsohn, JL; Shore-Lesserson, L; Ruggiero, A; Lim, G; Habib, AS
Published in: Int J Obstet Anesth
November 2022

BACKGROUND: Neuraxial administration of long-acting opioid is the "gold standard" for the management of postoperative pain following cesarean delivery. Respiratory depression, however, remains a concerning complication. METHODS: This retrospective single-center study of 4963 patients evaluated the frequency of respiratory depression after neuraxial morphine administration in a post-cesarean delivery population. The spinal dose of morphine varied from 100 to 450 µg intrathecally, and from 3 to 5 mg epidurally. The primary outcome was the initiation of a Rapid Response Team (RRT) event for respiratory failure due to neuraxial opioid in the 24 h following morphine administration. Secondary outcomes studied included oxygen desaturation events (SpO2 <90%), initiation of oxygen therapy and naloxone administration. RESULTS: There were no respiratory RRT events within the study period (95% confidence interval [CI] 0 to 7 per 10 000). There were no desaturation events recorded and no patients received supplemental oxygen therapy or naloxone (95% CI 0 to 7 per 10 000). CONCLUSION: Clinically significant respiratory depression is rare among patients receiving neuraxial morphine for post-cesarean delivery analgesia.

Duke Scholars

Published In

Int J Obstet Anesth

DOI

EISSN

1532-3374

Publication Date

November 2022

Volume

52

Start / End Page

103592

Location

Netherlands

Related Subject Headings

  • Retrospective Studies
  • Respiratory Insufficiency
  • Pregnancy
  • Pain, Postoperative
  • Oxygen
  • Naloxone
  • Morphine
  • Humans
  • Female
  • Anesthesiology
 

Citation

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Palleschi, G. T., Gerasimov, M., Blitz, M. J., Aronsohn, J. L., Shore-Lesserson, L., Ruggiero, A., … Habib, A. S. (2022). Respiratory depression after administration of single-dose neuraxial morphine for post-cesarean delivery analgesia: a retrospective cohort study. Int J Obstet Anesth, 52, 103592. https://doi.org/10.1016/j.ijoa.2022.103592
Palleschi, G. T., M. Gerasimov, M. J. Blitz, J. L. Aronsohn, L. Shore-Lesserson, A. Ruggiero, G. Lim, and A. S. Habib. “Respiratory depression after administration of single-dose neuraxial morphine for post-cesarean delivery analgesia: a retrospective cohort study.Int J Obstet Anesth 52 (November 2022): 103592. https://doi.org/10.1016/j.ijoa.2022.103592.
Palleschi GT, Gerasimov M, Blitz MJ, Aronsohn JL, Shore-Lesserson L, Ruggiero A, et al. Respiratory depression after administration of single-dose neuraxial morphine for post-cesarean delivery analgesia: a retrospective cohort study. Int J Obstet Anesth. 2022 Nov;52:103592.
Palleschi, G. T., et al. “Respiratory depression after administration of single-dose neuraxial morphine for post-cesarean delivery analgesia: a retrospective cohort study.Int J Obstet Anesth, vol. 52, Nov. 2022, p. 103592. Pubmed, doi:10.1016/j.ijoa.2022.103592.
Palleschi GT, Gerasimov M, Blitz MJ, Aronsohn JL, Shore-Lesserson L, Ruggiero A, Lim G, Habib AS. Respiratory depression after administration of single-dose neuraxial morphine for post-cesarean delivery analgesia: a retrospective cohort study. Int J Obstet Anesth. 2022 Nov;52:103592.
Journal cover image

Published In

Int J Obstet Anesth

DOI

EISSN

1532-3374

Publication Date

November 2022

Volume

52

Start / End Page

103592

Location

Netherlands

Related Subject Headings

  • Retrospective Studies
  • Respiratory Insufficiency
  • Pregnancy
  • Pain, Postoperative
  • Oxygen
  • Naloxone
  • Morphine
  • Humans
  • Female
  • Anesthesiology