Respiratory depression after administration of single-dose neuraxial morphine for post-cesarean delivery analgesia: a retrospective cohort study

Background: Neuraxial administration of long-acting opioid is the gold standard for the management of post -operative pain following cesarean delivery. Respiratory depression, however, remains a concerning complica-tion.Methods: This retrospective single-center study of 4963 patients evaluated the frequency of respiratory depres-sion after neuraxial morphine administration in a post-cesarean delivery population. The spinal dose of mor-phine varied from 100 to 450 mu g intrathecally, and from 3 to 5 mg epidurally. The primary outcome was the initiation of a Rapid Response Team (RRT) event for respiratory failure due to neuraxial opioid in the 24 h fol-lowing morphine administration. Secondary outcomes studied included oxygen desaturation events (SpO2 <90%), initiation of oxygen therapy and naloxone administration.Results: There were no respiratory RRT events within the study period (95% confidence interval [CI] 0 to 7 per 10 000). There were no desaturation events recorded and no patients received supplemental oxygen therapy or naloxone (95% CI 0 to 7 per 10 000).Conclusion: Clinically significant respiratory depression is rare among patients receiving neuraxial morphine for post-cesarean delivery analgesia.

Automated summary

This retrospective study evaluated the occurrence of respiratory depression after neuraxial morphine administration in post-cesarean delivery patients. The results indicate that clinically significant respiratory depression is rare among patients receiving neuraxial morphine for post-cesarean delivery analgesia.