Delayed respiratory depression after epidural morphine
Eldor, J.; Pizov, R.; Olshwang, D.
Harefuah 108(9): 441-443
1985
ISSN/ISBN: 0017-7768 PMID: 4029787 Document Number: 245670
The advantages of epidural opiates for the relief of postoperative pain have been emphasized repeatedly. However, delayed respiratory depression is a most serious hazard associated with regional opiate analgesia for pain management. This rare complication is attributed to drug redistribution through the cerebrospinal fluid to the brain stem respiratory center. This redistribution, which is influenced by the lipid solubility of the opiate, may occur slowly as a result of passive spread or suddenly due to changes in intrathecal volume. Three patients are described who developed delayed respiratory depression after epidural morphine. The recommended surveillance of patients for 12-24 hours after injection of epidural morphine is well-advised.