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Opioids, respiratory depression, and sleep-disordered breathing
Mahesh Nagappa1, Toby N Weingarten2, Gaspard Montandon3
1Department of Anesthesia & Perioperative Medicine, University Hospital, Victoria Hospital and St. Joseph Hospital, London Health Sciences Centre and St. Joseph Health Care, Western University, London, ON, Canada.
Best Practice & Research. Clinical Anaesthesiology
|May 10, 2018
Summary
Opioid use in surgery increases risks, especially for patients with sleep-disordered breathing (SDB). Opioids can cause respiratory depression, leading to dangerous events in unmonitored settings.
Area of Science:
- Anesthesiology
- Pulmonology
- Pharmacology
Background:
- Perioperative opioid use is rising, contributing to increased morbidity and mortality.
- Opioids are linked to sleep-disordered breathing (SDB) and respiratory depression.
- Postoperative pain management with opioids in SDB patients poses significant risks.
Purpose of the Study:
- To review the pathophysiology of opioid-induced respiratory depression.
- To examine the association between opioids and SDB.
- To highlight the risks of respiratory depression in SDB patients receiving opioids.
Main Methods:
- Literature review of existing studies.
- Synthesis of current knowledge on opioid effects and SDB.
- Appraisal of the relationship between opioid administration and SDB.
Main Results:
- Opioids can induce or worsen respiratory depression, particularly in patients with SDB.
- Unmonitored settings increase the risk of life-threatening respiratory events.
- Effective management strategies for this patient group require further investigation.
Conclusions:
- The interplay between opioids and SDB presents a critical challenge in perioperative care.
- Further research is essential for developing safe and effective management protocols.
- Preventing opioid-related respiratory depression in SDB patients is a priority.
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