The Incidence Of Postoperative Respiratory Depression In Patients Undergoing Intravenous Or Epidural Analgesia With Opioids

Duarte, Leonardo Teixeira Domingues; Fernandes, Maria do Carmo Barretto de Carvalho; Costa, Verônica Vieira da; Saraiva, Renato Ângelo

doi:10.1590/s0034-70942009000400003

Cited by 22 publications

(11 citation statements)

References 38 publications

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“…Unpredictable large interpatient variations in opioid responses and narrow therapeutic indices of opioids result in a high incidence of post operative opioid-related RD (up to 41%) [58,59], especially in children sensitive to opioids and who differ in physio logy and pharmacology from adults [60]. Identification of predictors for susceptibility remains key to preventing these events [61].…”

Section: Discussionmentioning

confidence: 99%

Fatty acid amide hydrolase–morphine interaction influences ventilatory response to hypercapnia and postoperative opioid outcomes in children

et al. 2017

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Aim: Fatty acid amide hydrolase (FAAH) degrades anandamide, an endogenous cannabinoid. We hypothesized that FAAH variants will predict risk of morphine-related adverse outcomes due to opioid-endocannabinoid interactions. Patients & methods:In 101 postsurgical adolescents receiving morphine analgesia, we prospectively studied ventilatory response to 5% CO 2 (HCVR), respiratory depression (RD) and vomiting. Blood was collected for genotyping and morphine pharmacokinetics. Results: We found significant FAAH-morphine interaction for missense (rs324420) and several regulatory variants, with HCVR (p < 0.0001) and vomiting (p = 0.0339). HCVR was more depressed in patients who developed RD compared with those who did not (p = 0.0034), thus FAAH-HCVR association predicts risk of impending RD from morphine use. Conclusion: FAAH genotypes predict risk for morphine-related adverse outcomes.

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Section: Discussionmentioning

confidence: 99%

Fatty acid amide hydrolase–morphine interaction influences ventilatory response to hypercapnia and postoperative opioid outcomes in children

et al. 2017

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“…So, to treat respiratory depression it is recommended: dose titration and reduction, use of opioid antagonist (intravenous 1-5µg/kg or 5µg/kg/h naloxone). On the other hand, buprenorphine-induced respiratory depression is only reverted by doxapram (IV 0.5-1.5 mg/kg every 5 minutes, maximum dose 2 mg/kg) 37 . Statements and recommendations for respiratory depression are shown in tables 5 and 6 [38][39][40][41][42][43] .…”

Section: Respiratory Depressionmentioning

confidence: 99%

Total temporomandibular joint alloplastic reconstruction

Ferreira¹,

Cunali²,

Bonotto³

et al. 2014

Revista Dor

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“…Most common adverse effects observed in the postoperative period are itching, nausea, vomiting, urinary retention, sleepiness, dizziness and constipation 2 . Most feared adverse effect is respiratory depression, the incidence of which is approximately 0.25% 3 . Continuous or intermittent intravenous administration of tramadol hydrochloride, morphine and fentanyl is indicated for moderate to severe pain or when the oral route cannot be used.…”

Section: Opioids For Postoperative Painmentioning

confidence: 99%

“…The infusion of local anesthetic solutions with opioids combines faster analgesia of local anesthetics and more prolonged opioids analgesia 3 . Epidural and subarachnoid routes provide more prolonged analgesia with lower concentrations as compared to the systemic route.…”

Section: Spinal Administrationmentioning

confidence: 99%

Recommendations for the use of opioids in Brazil: Part III. Use in special situations (postoperative pain, musculoskeletal pain, neuropathic pain, gestation and lactation)

et al. 2014

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BACKGROUND AND OBJECTIVES:The use of opioids as first and second line agents to adequately treat pain requires systematization in different clinical syndromes which course with acute pain. This study aimed at discussing recommendations for the use of opioids in acute postoperative pain, neuropathic pain, musculoskeletal pain and pain during gestation and lactation. CONTENTS: This review has addressed the use of opioids in frequent chronic and acute painful syndromes, in gestation and lactation, discussing indications, drugs used, doses, risks, complications and recommendations. CONCLUSION: Opioids for acute postoperative pain have been broadly studied and are established for minor medium and major surgeries. Recommendations for the use of opioids in neuropathic and musculoskeletal pain are restricted to second line treatment and require further discussions. Few studies have investigated the interaction of opioids with physiologic changes typical of gestation and the repercussions of the use of such agents to treat acute and chronic pain in the short and long term. Keywords: Gestation, Lactation, Musculoskeletal pain, Neuropathic pain, Opioid, Postoperative pain. Recommendations for the use of opioids in RESUMO JUSTIFICATIVA E OBJETIVOS:O emprego de opioides como agentes de primeira e segunda linha no tratamento da dor ainda é motivo de discussão na literatura. O uso de opioides de maneira adequada exige sistematização em diversas síndromes clínicas que cursam com dor aguda e crônica. O objetivo deste estudo foi discutir recomendações para o emprego de opioides na dor aguda de pós-operatório, na dor neuropática, na dor musculoesquelética e na dor durante a gestação e lactação. CONTEÚDO: Nesta revisão abordou-se o emprego de opioides em síndromes dolorosas agudas e crônicas frequentes, na gestação e lactação discutindo as indicações, os fármacos utilizados, as doses, os riscos, as complicações e as recomendações. CONCLUSÃO: O uso de opioides na dor aguda pós-operatória tem sido bem estudado e está estabelecido em cirurgias de pequeno, médio e grande porte. As recomendações para o emprego de opioides na dor neuropática e musculoesquelética são restritas à segunda linha de tratamento e exigem futuras discussões. Poucos estudos investigaram a interação dos opioides com as alterações fisiológicas próprias da gestação e as repercussões do emprego desses agentes no tratamento da dor aguda e crônica em curto e em longo prazo. Descritores: Dor musculoesquelética, Dor neuropática, Dor pós-operatória, Gestação, Lactação, Opioide.

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The Incidence Of Postoperative Respiratory Depression In Patients Undergoing Intravenous Or Epidural Analgesia With Opioids

Abstract: The incidence of respiratory depression was similar to that described in the literature; it is more frequent in children and adolescents, and with intravenous PCA.

Cited by 22 publications

References 38 publications

Fatty acid amide hydrolase–morphine interaction influences ventilatory response to hypercapnia and postoperative opioid outcomes in children

Fatty acid amide hydrolase–morphine interaction influences ventilatory response to hypercapnia and postoperative opioid outcomes in children

Total temporomandibular joint alloplastic reconstruction

Recommendations for the use of opioids in Brazil: Part III. Use in special situations (postoperative pain, musculoskeletal pain, neuropathic pain, gestation and lactation)

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