Abstract
Administration of epidural and intrathecal opioids may provide excellent postoperative analgesia, but a minority of patients will suffer dangerous respiratory depression. This review discusses the detection and measurement of respiratory depression and summarizes the relevant literature as it pertains to epidural and intrathecal opioid administration. The respiratory depressant effects and pharmacokinetics of spinal opioids are reviewed. The clinical implications and areas of future investigation are discussed.
Résumé
Ľinjection ďopiacés par voie péridurale ou intra-rachidienne pour fin ďanalgésie post-opératoire est efficace mais amène chez certains une dépression respiratoire importante. Cet article aborde les moyens de détection et de mesure de la dépression respiratoire associée à ces modes ďadministration et fait une revue de la littérature pertinente. Nous revoyons aussi le profil pharmacocinétique des opiacés rachidiens en relation avec leur pouvoir de dépression respiratoire. Finalement, nous en discutons les implications cliniques de même que les champs de recherche s’offrant à nous.
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Etches, R.C., Sandler, A.N. & Daley, M.D. Respiratory depression and spinal opioids. Can J Anaesth 36, 165–185 (1989). https://doi.org/10.1007/BF03011441
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DOI: https://doi.org/10.1007/BF03011441