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Anesth Analg 2008; 107:956-961
© 2008 International Anesthesia Research Society
doi: 10.1213/ane.0b013e318168b443
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 Course on Respiratory Depression after Neuraxial Opioids
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OBSTETRIC ANESTHESIOLOGY

Respiratory Depression After Neuraxial Opioids in the Obstetric Setting

Brendan Carvalho, MBBCh, FRCA

From the Department of Anesthesia, Stanford University School of Medicine, Stanford, California.

Address correspondence to Brendan Carvalho, MBBCh, FRCA, Department of Anesthesia, H3580, Stanford University School of Medicine, Stanford, CA 94305. Address e-mail to bcarvalho{at}stanford.edu.

Abstract

Neuraxial opioids have contributed significantly to improved labor and postcesarean delivery analgesia. In the obstetric population, epidural and intrathecal opioids are associated with a very low risk of clinically significant respiratory depression. Although rare, respiratory depression is a serious risk; patients may die or suffer permanent brain damage as a consequence. This review discusses the mechanism and incidence, as well as the prevention, detection, and management of respiratory depression with morphine, extended-release epidural morphine, and lipophilic opioids in the labor and cesarean delivery setting.




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Anesth. Analg., September 1, 2008; 107(3): 746 - 747.
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Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 2008 by the International Anesthesia Research Society.