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Respiratory depression after neuraxial opioids in the obstetric setting
1Department of Anesthesia, Stanford University School of Medicine, Stanford, CA 94305, USA. bcarvalho@stanford.edu
Abstract:
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.
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