Respiratory depression after neuraxial opioids in the obstetric setting.
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.
Carvalho
Brendan
B
Department of Anesthesia, Stanford University School of Medicine, Stanford, CA 94305, USA. bcarvalho@stanford.edu
D000698:Analgesia; D016362:Analgesia, Obstetrical / Q000379:methods*; D000701:Analgesics, Opioid / Q000009:adverse effects* / Q000627:therapeutic use*; D036861:Delivery, Obstetric; D005260:Female; D006801:Humans; D007743:Labor, Obstetric; D016343:Monitoring, Intraoperative; D009020:Morphine / Q000008:administration & dosage*; D009774:Obstetrics / Q000379:methods*; D010146:Pain; D010149:Postoperative Pain; D011247:Pregnancy; D012131:Respiratory Insufficiency / Q000209:etiology*; D012306:Risk
D000701:Analgesics, Opioid; D009020:Morphine