The Relationship Between Timing of Opioid Administration and Postoperative Respiratory Depression.
Wayne State University
Summary
The goal of this study is to determine if a relationship can be detected between the administration of an opioid and quantitative respiratory depression in spontaneously breathing non-intubated patients who have undergone general anesthesia and have received perioperative opioids. The primary aim is to determine the temporal effect of opioid administration on respiratory depression as assessed by minute ventilation with a reduction of at least 20% in the percent of predicted minute ventilation. A secondary aim is to determine a dose response of opioid administration and its effect on minute ventilation. The investigators aim to determine the influence of opioid administration on minute ventilation on spontaneously breathing patients during post-anesthesia care unit (PACU) stay.
Description
Opioids have been used as a mainstay of perioperative analgesia since the late 18th century. The use of opioids, however, is not without risk as both short-term and long-term complications have been reported leading to in-hospital morbidity as well as increased 30-day readmission. Multiple postoperative complications are attributed to opioid administration including respiratory, cardiovascular, neurological, and gastrointestinal. As such, the routine use of opioids postoperatively is constantly being re-evaluated in search of better alternatives. For the time being, opioid prescription is larg…
Eligibility
- Age range
- 18–85 years
- Sex
- All
- Healthy volunteers
- Yes
Inclusion Criteria: * Written informed consent * Adults ≥18 years of age and ≤85 years of age * Patients planned for general anesthesia with an expected anesthetic time of at least 2 hours * Patients expected to receive postoperative opioid analgesia Exclusion Criteria: * Non-operative procedure (imaging) * Patients not admitted to the PACU postoperatively * Use of patient-controlled analgesia systems * Female patients who are pregnant or breastfeeding * Patients with asymmetric lung disease * American Society of Anesthesiologists (ASA) classification V * Emergency surgery (ASA E Modifier)
Interventions
- Diagnostic TestRespiratory volume monitoring
Noninvasive continuous respiratory monitoring utilizing bio-impedance to detect tidal volumes, respiratory rate, and minute ventilation.
Location
- Detroit Medical CenterMount Clemens, Michigan