Surgery, opioids and respiratory compromise

Posted 5/16/18

(BPT) — There is a serious epidemic of opioid-related drug addiction in the United States, accompanied by an alarming increase in opioid-related drug overdose deaths. In addition to the …

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Surgery, opioids and respiratory compromise

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(BPT) — There is a serious epidemic of opioid-related drug addiction in the United States, accompanied by an alarming increase in opioid-related drug overdose deaths. In addition to the non-prescription use of opioids, administration of prescribed opioids in hospital settings, especially in combination with anesthesia and other sedating medications, may cause respiratory depression, which can lead to respiratory compromise—a potentially life threatening state of unstable respiratory health. If respiratory compromise goes unrecognized and is left untreated, it can result in respiratory failure, and even death.

People with certain risk factors—obstructive sleep apnea, older age, obesity and chronic obstructive pulmonary disease—have a greater chance of developing progressive respiratory compromise. These risk factors, when present in patients receiving opioids for pain relief or sedation, can potentially increase the possibility of respiratory compromise and should be identified by screening patients prior to opioid administration to enable better, safer care.

“It is crucial that patients understand their risk of respiratory compromise when given opioids while undergoing or recovering from a surgical procedure,” said Carla R. Jungquist, PhD, ANP-BC, FAAN, Associate Professor, University at Buffalo, The State of New York, School of Nursing, Buffalo, N.Y. “In addition, healthcare professionals should use responsible opioid prescribing and administration practices, along with appropriate monitoring practices tailored to individual patient needs, to promote safer and improved pain control while also decreasing the risk of respiratory compromise.”

Life-threatening respiratory compromise (for example, respiratory arrest) can be avoided by using appropriate monitoring technologies to evaluate a patient’s respiratory status. Healthcare professionals, using electronic monitoring technologies, can detect and manage respiratory compromise earlier and more effectively. One such technology, capnography, which measures the level of carbon dioxide in a person’s exhaled breath, may help identify respiratory compromise in its earliest stage.

Visit http://www.respiratorycompromise.org/ to learn more about respiratory compromise.

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