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Apnea and bradypnea in patients receiving epidural bupivacaine-morphine for postoperative pain relief as assessed by a new monitoring method.

Flisberg, Per LU ; Jakobsson, Jan and Lundberg, Johan LU (2002) In Journal of Clinical Anesthesia 14(2). p.129-134
Abstract
STUDY OBJECTIVE: To evaluate postoperative breathing patterns with a new monitoring device in patients given bupivacaine-morphine epidural analgesia. DESIGN: Open explorative study. SETTING: Inpatient anesthesia in a university hospital setting. PATIENTS: 15 ASA physical status I and II patients aged 28 to 87 years and scheduled for major abdominal surgery. INTERVENTIONS: All patients underwent abdominal surgery with epidural anesthesia combined with general anesthesia. Postoperatively, they continued with epidural analgesia consisting of bupivacaine and morphine. On the first postoperative night, the breathing pattern was studied with a new noninvasive monitoring device measuring respiratory frequency and apnea. Arterial blood gas... (More)
STUDY OBJECTIVE: To evaluate postoperative breathing patterns with a new monitoring device in patients given bupivacaine-morphine epidural analgesia. DESIGN: Open explorative study. SETTING: Inpatient anesthesia in a university hospital setting. PATIENTS: 15 ASA physical status I and II patients aged 28 to 87 years and scheduled for major abdominal surgery. INTERVENTIONS: All patients underwent abdominal surgery with epidural anesthesia combined with general anesthesia. Postoperatively, they continued with epidural analgesia consisting of bupivacaine and morphine. On the first postoperative night, the breathing pattern was studied with a new noninvasive monitoring device measuring respiratory frequency and apnea. Arterial blood gas analysis was performed in case of apnea or low respiratory frequency. MEASUREMENTS AND MAIN RESULTS: A total of 84 alarm events were registered in 11 patients. Twenty-one percent (18/84) of the alarms were associated with arterial carbon dioxide tension (PaCO2) levels greater than 48.8 mmHg. Three of the four patients with PaCO2 levels greater than 48.8 mmHg were older than 80 years of age. CONCLUSION: The tested noninvasive monitoring device may detect abnormal respiratory breathing patterns in patients at risk for respiratory depression during epidural analgesia with bupivacaine-morphine. (Less)
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published
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keywords
Bupivacaine : adverse effects, Physiologic, Monitoring, Middle Age, Male, Human, Carbon Dioxide : blood, Female, Apnea : etiology, Apnea : diagnosis, Local : adverse effects, Anesthetics, Analgesics, Opioid : adverse effects, Epidural : adverse effects, Analgesia, 80 and over, Aged, Adult, Morphine : adverse effects, Pain, Postoperative : prevention & control, Respiration Disorders : diagnosis, Respiration Disorders : etiology
in
Journal of Clinical Anesthesia
volume
14
issue
2
pages
129 - 134
publisher
Elsevier
external identifiers
  • wos:000175105100012
  • pmid:11943527
  • scopus:0036203981
ISSN
1873-4529
DOI
10.1016/S0952-8180(01)00369-5
language
English
LU publication?
yes
id
7054fef7-5e08-474d-bcd9-60ea4d7aa1d3 (old id 107507)
alternative location
http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11943527&dopt=Abstract
date added to LUP
2007-06-28 08:56:10
date last changed
2017-01-01 04:50:26
@article{7054fef7-5e08-474d-bcd9-60ea4d7aa1d3,
  abstract     = {STUDY OBJECTIVE: To evaluate postoperative breathing patterns with a new monitoring device in patients given bupivacaine-morphine epidural analgesia. DESIGN: Open explorative study. SETTING: Inpatient anesthesia in a university hospital setting. PATIENTS: 15 ASA physical status I and II patients aged 28 to 87 years and scheduled for major abdominal surgery. INTERVENTIONS: All patients underwent abdominal surgery with epidural anesthesia combined with general anesthesia. Postoperatively, they continued with epidural analgesia consisting of bupivacaine and morphine. On the first postoperative night, the breathing pattern was studied with a new noninvasive monitoring device measuring respiratory frequency and apnea. Arterial blood gas analysis was performed in case of apnea or low respiratory frequency. MEASUREMENTS AND MAIN RESULTS: A total of 84 alarm events were registered in 11 patients. Twenty-one percent (18/84) of the alarms were associated with arterial carbon dioxide tension (PaCO2) levels greater than 48.8 mmHg. Three of the four patients with PaCO2 levels greater than 48.8 mmHg were older than 80 years of age. CONCLUSION: The tested noninvasive monitoring device may detect abnormal respiratory breathing patterns in patients at risk for respiratory depression during epidural analgesia with bupivacaine-morphine.},
  author       = {Flisberg, Per and Jakobsson, Jan and Lundberg, Johan},
  issn         = {1873-4529},
  keyword      = {Bupivacaine : adverse effects,Physiologic,Monitoring,Middle Age,Male,Human,Carbon Dioxide : blood,Female,Apnea : etiology,Apnea : diagnosis,Local : adverse effects,Anesthetics,Analgesics,Opioid : adverse effects,Epidural : adverse effects,Analgesia,80 and over,Aged,Adult,Morphine : adverse effects,Pain,Postoperative : prevention & control,Respiration Disorders : diagnosis,Respiration Disorders : etiology},
  language     = {eng},
  number       = {2},
  pages        = {129--134},
  publisher    = {Elsevier},
  series       = {Journal of Clinical Anesthesia},
  title        = {Apnea and bradypnea in patients receiving epidural bupivacaine-morphine for postoperative pain relief as assessed by a new monitoring method.},
  url          = {http://dx.doi.org/10.1016/S0952-8180(01)00369-5},
  volume       = {14},
  year         = {2002},
}