Perioperative Respiratory Depression and Monitoring

Opiate-related respiratory depression has not been eliminated by the use of patient-controlled analgesia (PCA). Respiratory depression may be caused by PCA pump programming errors and mechanical malfunction, and patient risk factors such as advanced age, obstructive sleep apnea and m-receptor polymorphisms. Administration of the proper dose of opiate and the avoidance of drug interactions may reduce the risk of respiratory depression. Attempts to improve the safe use of opiates by better patient selection and limiting the use of these drugs to patients in high-intensity monitoring units are not practical. The safe use of opiates may be enhanced by incorporating respiratory pattern analysis into postoperative monitoring technology.