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Roshini Claire Anthony, 5 days ago

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Mild respiratory depression common after epidural morphine for C-section

19 May 2019

Mild respiratory depression appears to be common in women given epidural morphine after caesarean delivery, a new study suggests.

Researchers prospectively assessed 100 women scheduled to undergo elective caesarean section delivery and to receive postoperative 3 mg epidural morphine. All participants were fitted with the Nellcor respiratory rate monitoring system. Respiratory depression was defined as both bradypnoea and oxygen desaturation for more than 1 minute.

Of the participants, 42 (mean age, 32.4±4.9 years) did not experience respiratory depression. These patients tended to be younger than those with the condition (n=47; mean age, 34.5±4.6 years; p=0.04). Both groups of participants had a median of 38 gestational weeks (p=0.45) and were of comparable body mass indices (26.5±3.6 vs 25.1±3.1 kg/m2; p=0.06).

There were 46 cases (52 percent) of mild and one of moderate respiratory depression. There were no reports of severe respiratory depression. The median time to the first depression event from morphine administration was 3.2 hours.

Over a median monitoring duration of 19.0 hours, 85 percent (n=76) of the participants developed at least one episode of bradypnoea (respiratory rate 10 breaths per minute) while 12 percent (n=11) experienced moderate desaturation.

Intramuscular tramadol was administered in 13 patients for pain relief, but no one required supplemental opioids. There was also no need for supplemental oxygen or naloxone. The proportion of patients with respiratory depression remained stable until the point of first ambulation.

Univariate analysis showed that aside from patient age, body mass index, gestational week, intraoperative fluid volume, or the use of medications such as tramadol or droperidol were not potential predictive factors for the development of respiratory depression.

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Most Read Articles
Roshini Claire Anthony, 5 days ago

Beta-blockers could reduce mortality risk in patients with heart failure with reduced ejection fraction (HFrEF) and moderate or moderately-severe renal dysfunction without causing harm, according to the BB-META-HF* trial presented at ESC 2019.

Stephen Padilla, 6 days ago
Implementation of the collaborative care in a rheumatoid arthritis (RA) clinic has led to improvements in nonbiologic disease-modifying antirheumatic drugs (nb-DMARDs) optimization, adherence to safety recommendations on nb-DMARD monitoring and detection of adverse drug events in RA patients, according to a Singapore study.
5 days ago
Blood pressure (BP) in children is influenced by early-life exposure to several chemicals, built environment and meteorological factors, suggests a study.
5 days ago
Short sleep duration is associated with an increased risk of myocardial infarction (MI), according to prospective observational and Mendelian randomization (MR) analyses.