Monitoring,prevention and treatment of side effects of long-acting neuraxial opioids for post-cesarean analgesia |
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| Affiliation: | 1. Department of Surgery, University of South Carolina School of Medicine Greenville, Greenville, SC;2. Summer Undergraduate Research Program, University of South Carolina School of Medicine Greenville, Greenville, SC;3. Department of Anesthesiology, University of South Carolina School of Medicine Greenville, Greenville, SC;4. University of South Carolina School of Medicine Greenville, Greenville, SC;5. Department of Quality Management, Greenville Health System, Greenville, SC;1. Department of Orthopaedics, Kaohsiung Veterans General Hospital, Taiwan;2. Department of Anesthesiology, National Cheng Kung University Hospital, Tainan, Taiwan;3. Institute of Clinical Pharmacy and Pharmaceutical Science, National Cheng Kung University, Taiwan;4. Nursing College, Fooyin University, Kaohsiung, Taiwan;1. Department of Anesthesiology, Baylor College of Medicine, Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX, USA;2. Kamuzu Central Hospital, Lilongwe, Malawi;3. Department of Obstetrics & Gynecology, Baylor College of Medicine, Houston, TX, USA;4. Dept. of Surgery, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA;1. Department of Women’s & Obstetric Anaesthesia, IWK Health Centre, Halifax, Nova Scotia, Canada;2. Department of Obstetrics and Gynaecology, IWK Health Centre, Halifax, Nova Scotia, Canada;3. Department of Anesthesia, Dalhousie University, Halifax, Nova Scotia, Canada;1. Department of Anesthesia, Pain and Perioperative Medicine, University of Miami Miller School of Medicine, Miami, FL, USA;2. Department of Anesthesiology, University of Arkansas for Medical Science, Little Rock, AR, USA;3. Department of Anesthesia, Pain and Perioperative Medicine, Stanford School of Medicine, California, USA |
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| Abstract: | Long-acting neuraxial opioids such as morphine and diamorphine, administered via spinal or epidural routes, are staple components of a multimodal approach to postoperative analgesia following cesarean delivery. The widespread use of neuraxial opioids is due largely to their significant analgesic efficacy and favorable safety profile. The most common side effects of neuraxial opioids are pruritus, nausea and vomiting. These symptoms appear to be dose-related. The most serious complication of neuraxial opioids is respiratory depression, which occurs in 0–0.9% of cases. Hypothermia has also been reported in association with neuraxial morphine use at cesarean delivery. This article will review recent advances in prophylaxis, treatment and monitoring of the side effects of long-acting neuraxial opioids. |
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| Keywords: | Opioids, neuraxial Cesarean Nausea Vomiting Pruritus Hypothermia Respiratory depression |
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