Postoperative Epidural Morphine is Safe on Surgical Wards

Ready, L. B.; Loper, Keith A.; Nessly, Michael L.; Wild, Lorie Rietman

doi:10.1097/00132586-199236030-00038

Cited by 39 publications

(65 citation statements)

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“…2~ However, Ready reported a large series of patients who received this form of analgesia safely on regular wards and suggested guidelines to ensure the safe administration of EOA. 16 Combinations of opioids and local anaesthetics for epidural administration have also been used for control of postoperative pain, with many centres reporting their safe and effective use, 22-24 although this view is not held by all. 2s…”

Section: En D~cembre 1991 Un Questionnaire Sure L'exercice De La Th~mentioning

confidence: 99%

“…It appears that most hospitals would support the view of other investigators that standardized nursing procedure protocols and an educated nursing staff are more effective than apnoea monitors and continuous pulse oximetry for monitoring postoperative patients receiving EOA. 13,16,31 The incidence of respiratory depression is difficult to determine as it depends on the definition of respiratory depression and how it is monitored. In this survey the incidence of "severe respiratory depression" with the use of EOA and PCA was estimated as 0.13% and 0.03% respectively.…”

Section: Pca and Eoa Use In Canadamentioning

confidence: 99%

See 1 more Smart Citation

Postoperative pain management and Acute Pain Service activity in Canada

Zimmermann

Stewart

1993

Can J Anaesth

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Section: En D~cembre 1991 Un Questionnaire Sure L'exercice De La Th~mentioning

confidence: 99%

Section: Pca and Eoa Use In Canadamentioning

confidence: 99%

Postoperative pain management and Acute Pain Service activity in Canada

Zimmermann

Stewart

1993

Can J Anaesth

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“…Some investigators report respiratory depression on the basis of requirement for naloxone reversal (2,9,11,31), indicating a relatively severe complication. When this definitive criterion is used, the reported rate of respiratory depression with epidural opioids is 0.2-0.4% (2,9,11).…”

Section: Discussionmentioning

confidence: 99%

The Safety of Concurrent Administration of Opioids via Epidural and Intravenous Routes for Postoperative Pain in Pediatric Oncology Patients

Anghelescu

Ross

Oakes

et al. 2008

Journal of Pain and Symptom Management

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Supplementation of epidural opioid analgesia with intravenous opioids is usually avoided because of concern about respiratory depression. However, the choice of adjunct analgesic agents for pediatric oncology patients is limited. Antipyretic drugs may mask fever in neutropenic patients, and nonsteroidal anti-inflammatory agents may exert anti-platelet effects and interact with chemotherapeutic agents. We examined the safety of concurrent use of epidural and intravenous opioids in a consecutive series of 117 epidural infusions in pediatric patients and compared our findings to those reported by other investigators. We observed a 0.85% rate of clinically significant respiratory complications. The single adverse event was associated with an error in dosage. In our experience, the supplementation of epidural opioid analgesia with intravenous opioids has been a safe method of postoperative pain control for pediatric patients with cancer.

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“…In fact, the limited data suggest that the incidence may be greater with PCA than with epidural opioid administration. [1][2][3][4] This paper reviews eight cases of severe respiratory depression occurring in patients receiving PCA at the University of Alberta Hospitals.…”

Section: L'apparition De Cette Complication Avec Cet Objectif En Vuementioning

confidence: 99%