Supplemental oxygen is not required in trauma patients treated with IV opiates.
The risk of respiratory depression can prevent the proper use of opioids in trauma patients and lead to use of supplemental oxygen. However, high FiO(2) might contribute to atelectasis formation and consequently to relative hypoxia. Supplemental oxygen also can cause a risk of fire. In a randomized, controlled study we evaluated the need and effects of supplemental oxygen in 13 patients with extremity trauma who were treated pain-free with an intravenous opioid, oxycodone (dose range 6.75-13.6 mg). After opioid injection, 7 patients received 40% supplemental oxygen and 6 were breathing room air. Pulse oxygen saturation (SpO(2)), arterial blood gases, and hemodynamic parameters were monitored for 30 minutes. Atelectasis formation was evaluated with a computed tomography scan. No hypoxia, hypoventilation, or significant atelectasis formation was detected in any of the patients. Accordingly, routinely given supplemental oxygen was not considered necessary in these patients because no complications were seen.
Mildh
Leena H
LH
Department of Anesthesia and Intensive Care Medicine, Helsinki University Hospital, Helsinki, Finland.
Piilonen
Anneli
A
Kirvelä
Olli A
OA
D000328:Adult; D000701:Analgesics, Opioid / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use*; D005121:Extremities / Q000293:injuries*; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D020380:Needs Assessment; D010098:Oxycodone / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use*; D010102:Oxygen Inhalation Therapy / Q000009:adverse effects*; D010146:Pain / Q000188:drug therapy* / Q000209:etiology*; D001261:Pulmonary Atelectasis / Q000209:etiology*; D012131:Respiratory Insufficiency / Q000139:chemically induced / Q000517:prevention & control*; D014947:Wounds and Injuries / Q000150:complications* / Q000628:therapy*
D000701:Analgesics, Opioid; D010098:Oxycodone