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A Prospective Study of Post-cesarean Delivery Hypoxia After Spinal Anesthesia With Intrathecal Morphine 150 μg

Ladha, K.S.; Kato, R.; Tsen, L.C.; Bateman, B.T.; Okutomi, T.

doi: 10.1097/01.aoa.0000542392.10717.ab
Anesthesia and Analgesia: Postoperative Analgesia

(Int J Obstet Anesth. 2017;32:48–53)

Neuraxial morphine is one of the most common postoperative analgesia techniques for women who have undergone cesarean delivery. Delayed respiratory depression is a concerning side effect of intrathecal morphine (ITM), as it can potentially increase morbidity and mortality. While the incidence of bradypnea associated with ITM has been reported to be 0.25% or lower, this rate may not account for all cases of ITM-induced respiratory depression because respiratory rate was not continuously monitored in the studies from which these rate were calculated. In addition, patients may develop hypoxia or hypercarbia without the presence of bradypnea. This study aimed to analyze the incidence and timing of hypoxic events in patients receiving post-cesarean analgesia in the form of ITM 150 μg, in order to better define populations at risk of developing hypoxia following ITM.

Department of Anesthesiology, University of Toronto and Toronto General Hospital, Toronto, ON, Canada

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