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Respiratory depression following epidural morphine: a clinical study
Canadian Anaesthetists' Society Journal
|September 1, 1986
Summary
Epidural morphine causes more significant postoperative respiratory depression than intravenous morphine in patients after thoracotomy. Electronic monitoring is crucial for detecting respiratory risks associated with epidural morphine.
Area of Science:
- Anesthesiology
- Critical Care Medicine
- Pharmacology
Background:
- Post-thoracotomy pain management often involves morphine.
- Respiratory depression is a significant concern with opioid analgesia.
Purpose of the Study:
- To compare the effects of epidural versus intravenous morphine on postoperative respiratory depression.
- To assess respiratory parameters in patients receiving different morphine administration routes.
Main Methods:
- A double-blind, randomized clinical trial involving 13 post-thoracotomy patients.
- Comparison of epidural morphine (Group E) and intravenous morphine (Group I).
- Assessment of PaCO2, respiratory rate (RR), shallow respiratory rate (SRR), and hypopnoea/apnoea (H/A) over 24 hours using respiratory inductive plethysmography.
Main Results:
- Epidural morphine led to significantly elevated PaCO2 at 2, 6, and 12 hours compared to intravenous morphine.
- Multiple episodes of SRR and H/A were significantly more frequent in the epidural morphine group.
- Intravenous morphine showed minimal impact on respiratory parameters.
Conclusions:
- Multiple doses of epidural morphine can cause unpredictable respiratory pattern changes.
- Epidural morphine poses a higher risk of significant postoperative respiratory depression.
- Electronic monitoring is valuable for identifying patients at risk of respiratory complications from epidural morphine.
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